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      A systematic review of determinants of sedentary behaviour in youth: a DEDIPAC-study

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          Abstract

          Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe ( n = 13), USA ( n = 11), and Australia ( n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74–91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth.

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          The online version of this article (doi:10.1186/s12966-015-0291-4) contains supplementary material, which is available to authorized users.

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          Most cited references60

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          A review of correlates of physical activity of children and adolescents.

          Understanding the factors that influence physical activity can aid the design of more effective interventions. Previous reviews of correlates of youth physical activity have produced conflicting results. A comprehensive review of correlates of physical activity was conducted, and semiquantitative results were summarized separately for children (ages 3-12) and adolescents (ages 13-18). The 108 studies evaluated 40 variables for children and 48 variables for adolescents. About 60% of all reported associations with physical activity were statistically significant. Variables that were consistently associated with children's physical activity were sex (male), parental overweight status, physical activity preferences, intention to be active, perceived barriers (inverse), previous physical activity, healthy diet, program/facility access, and time spent outdoors. Variables that were consistently associated with adolescents' physical activity were sex (male), ethnicity (white), age (inverse), perceived activity competence, intentions, depression (inverse), previous physical activity, community sports, sensation seeking, sedentary after school and on weekends (inverse), parent support, support from others, sibling physical activity, direct help from parents, and opportunities to exercise. These consistently related variables should be confirmed in prospective studies, and interventions to improve the modifiable variables should be developed and evaluated.
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            Methods of Measurement in epidemiology: sedentary Behaviour.

            Research examining sedentary behaviour as a potentially independent risk factor for chronic disease morbidity and mortality has expanded rapidly in recent years. We present a narrative overview of the sedentary behaviour measurement literature. Subjective and objective methods of measuring sedentary behaviour suitable for use in population-based research with children and adults are examined. The validity and reliability of each method is considered, gaps in the literature specific to each method identified and potential future directions discussed. To date, subjective approaches to sedentary behaviour measurement, e.g. questionnaires, have focused predominantly on TV viewing or other screen-based behaviours. Typically, such measures demonstrate moderate reliability but slight to moderate validity. Accelerometry is increasingly being used for sedentary behaviour assessments; this approach overcomes some of the limitations of subjective methods, but detection of specific postures and postural changes by this method is somewhat limited. Instruments developed specifically for the assessment of body posture have demonstrated good reliability and validity in the limited research conducted to date. Miniaturization of monitoring devices, interoperability between measurement and communication technologies and advanced analytical approaches are potential avenues for future developments in this field. High-quality measurement is essential in all elements of sedentary behaviour epidemiology, from determining associations with health outcomes to the development and evaluation of behaviour change interventions. Sedentary behaviour measurement remains relatively under-developed, although new instruments, both objective and subjective, show considerable promise and warrant further testing.
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              Canadian sedentary behaviour guidelines for children and youth.

              The Canadian Society for Exercise Physiology (CSEP), in partnership with the Healthy Active Living and Obesity Research Group (HALO) at the Children's Hospital of Eastern Ontario Research Institute, and in collaboration with ParticipACTION, and others, has developed the Canadian Sedentary Behaviour Guidelines for Children (aged 5-11 years) and Youth (aged 12-17 years). The guidelines include a preamble to provide context, followed by the specific recommendations for sedentary behaviour. The entire development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process and the recommendations are based on evidence from a systematic review and interpretation of the research evidence. The final guidelines benefitted from an extensive online consultation process with 230 domestic and international stakeholders and key informants. The final guideline recommendations state that for health benefits, children (aged 5-11 years) and youth (aged 12-17 years) should minimize the time that they spend being sedentary each day. This may be achieved by (i) limiting recreational screen time to no more than 2 h per day - lower levels are associated with additional health benefits; and (ii) limiting sedentary (motorized) transport, extended sitting time, and time spent indoors throughout the day. These are the first evidence-based Canadian Sedentary Behaviour Guidelines for Children and Youth and provide important and timely recommendations for the advancement of public health based on a systematic synthesis, interpretation, and application of the current scientific evidence.
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                Author and article information

                Contributors
                annabel.stierlin@uni-ulm.de
                sara.delepeleere@ugent.be
                greet.cardon@ugent.be
                patricia.dargent@inserm.fr
                belinda.hoffmann@uni-ulm.de
                mh.murphy@ulster.ac.uk
                aileen.m.kennedy@dcu.ie
                grainne.odonoghue@dcu.ie
                sebastien.chastin@gcu.ac.uk
                marieke.decraemer@ugent.be
                Journal
                Int J Behav Nutr Phys Act
                Int J Behav Nutr Phys Act
                The International Journal of Behavioral Nutrition and Physical Activity
                BioMed Central (London )
                1479-5868
                9 October 2015
                9 October 2015
                2015
                : 12
                : 133
                Affiliations
                [ ]Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
                [ ]Section Health Economics and Health Services Research, Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Ulm, Germany
                [ ]Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
                [ ]Univ Paris Descartes, UMRS 1153, F-94807 Villejuif, France
                [ ]Division of Sports and Rehabilitation Medicine, Department of Medicine II, Ulm University, Ulm, Germany
                [ ]Sport and Exercise Sciences Research Institute, University of Ulster, Northern Ireland, UK
                [ ]Centre for Preventive Medicine, Dublin City University, Dublin, Ireland
                [ ]Institute of Applied Health Research, School of Health and Life Science, Glasgow Caledonian University, Glasgow, Scotland UK
                [ ]Inserm U1153, ORCHARD, Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité (CRESS), Villejuif, F-94807 France
                Article
                291
                10.1186/s12966-015-0291-4
                4600309
                26453175
                c4b6cf58-7704-4d45-bbc6-3e1d276797af
                © Stierlin et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 11 April 2015
                : 25 September 2015
                Categories
                Review
                Custom metadata
                © The Author(s) 2015

                Nutrition & Dietetics
                children,adolescents,youth,sedentary behaviour,screen time,sitting,determinant
                Nutrition & Dietetics
                children, adolescents, youth, sedentary behaviour, screen time, sitting, determinant

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