Active school transport and weekday physical activity in 9-11-year-old children from 12 countries

Abstract

Objectives: Active school transport (AST) may increase the time that children spend in physical activity (PA). This study examined relationships between AST and weekday moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary time (SED) and total activity during naturally organized time periods (daily, before school, during school and after school) in a sample of children from 12 countries.

Methods: The sample included 6224 children aged 9-11 years. PA and sedentary time were objectively measured using Actigraph accelerometers. AST was self-reported by participants. Multilevel generalized linear and logistic regression statistical models were used to determine associations between PA, SED and AST across and within study sites.

Results: After adjustment for age, highest parental educational attainment, BMI z-score and accelerometer wear time, children who engaged in AST accumulated significantly more weekday MVPA during all studied time periods and significantly less time in LPA before school compared with children who used motorized transport to school. AST was unrelated to time spent in sedentary behaviors. Across all study sites, AST was associated with 6.0 min (95% confidence interval (CI): 4.7-7.3; P<0.0001) more of weekday MVPA; however, there was some evidence that this differed across study sites (P for interaction=0.06). Significant positive associations were identified within 7 of 12 study sites, with differences ranging from 4.6 min (95% CI: 0.3-8.9; P=0.04, in Canada) to 10.2 min (95% CI: 5.9-14.4; P<0.0001, in Brazil) more of daily MVPA among children who engaged in AST compared with motorized transport.

Conclusions: The present study demonstrated that AST was associated with children spending more time engaged in MVPA throughout the day and less time in LPA before school. AST represents a good behavioral target to increase levels of PA in children.

Figure 1

The difference in mean school day MVPA among children who engage in AST compared with motorized transport to school in n=6224 9–11-year-old children. Means are adjusted for sex, BMI z-score, age, highest parental educational attainment, accelerometer waking wear time, site by AST interaction and school nested within site was treated as a fixed effect in the multilevel analysis. Error bars represent 95% confidence intervals.

Figure 2

Associations between AST and obtaining at least 60 min of MVPA per school day in n=6224 9–11-year-old children from 12 countries. Odds ratios are adjusted for sex, BMI z-score, age, highest parental educational attainment, accelerometer waking wear time, site by AST interaction and school nested within site was treated as a fixed effect in the multilevel analysis. Error bars represent 95% confidence intervals.