Comparison of two methods to assess physical activity prevalence in children: an observational study using a nationally representative sample of Scottish children aged 10-11 years

Abstract

Objectives: To describe the objectively measured levels of physical activity (PA) and sedentary time in a nationally representative sample of 10-11-year-old children, and compare adherence estimates to the UK PA guidelines using two approaches to assessing prevalence.

Design: Nationally representative longitudinal cohort study.

Setting: Scotland wide in partnership with the Growing up in Scotland (GUS) study. Data collection took place between May 2015 and May 2016.

Participants: The parents of 2402 GUS children were approached and 2162 consented to contact. Consenting children (n=1096) wore accelerometers for 8 consecutive days and 774 participants (427 girls, 357 boys) met inclusion criteria.

Primary and secondary outcome measures: Total PA (counts per minute, cpm); time spent sedentary and in moderate-to-vigorous PA (MVPA); proportion of children with ≥60 min MVPA on each day of wear (daily approach); proportion of children with ≥60 min of MVPA on average across days of wear (average approach)-presented across boys and girls, index of multiple deprivation and season.

Results: Mean PA level was 648 cpm (95% CI, 627 to 670). Children spent 7.5 hours (7.4-7.6) sedentary/day and 72.6 min (70.0-75.3) in MVPA/day. 11% (daily) and 68% (average) of children achieved the recommended levels of PA (P<0.05 for difference); a greater proportion of boys met the guidelines (12.5% vs 9.8%, NS; 75.9% vs 59.5%, P<0.001); guideline prevalence exhibited seasonal variation. No significant socioeconomic patterning existed across any outcome measure.

Conclusions: PA estimates are significantly influenced by the analytical method used to assess prevalence. This could have a substantial impact on the evaluation of interventions, policy objectives and public health investment. Existing guidelines, which focus on daily PA only may not further our understandings about the underlying construct itself. Gender differences exist within this age-group, suggesting greater investment, with particular consideration of seasonality, is needed for targeted intervention work in younger children.

Keywords: Child; Exercise; Prevalence.

Figure 1

Physical activity prevalence across season of measurement by sex and measurement approach. *P<0.01; Statistically significant difference between boys and girls within season. ‡ Statistically significant interaction between gender and season, P<0.05. Figures are predicted probabilities and significance testing is adjusted for mean wear time and number of valid days.

Figure 2

Physical activity prevalence by sex and threshold classification reference—daily and average approaches. *P<0.01, **P<0.001; statistically significant difference between boys and girls within threshold reference point and measurement approach. Figures are predicted probabilities and significance testing is adjusted for season of measurement, mean wear time, and number of valid days.