A repeated measurement study investigating the impact of school outdoor environment upon physical activity across ages and seasons in Swedish second, fifth and eighth graders

BMC Public Health

Cecilia Boldemann¹  Maria Kylin⁴  Fredrika Mårtensson⁴  Antonio Ponce De Leon³  Anders Raustorp²  Peter Pagels³ 

[1]Center for Epidemiology and Community Medicine, Stockholm County Council, SE, Sweden

[2]Department of Food and Nutrition, and Sport Sciences, University of Gothenburg, Gothenburg, SE, Sweden

[3]Department of Public Health Sciences, Karolinska Institutet, Stockholm, SE, Sweden

[4]Swedish University of Agricultural Sciences, Alnarp, SE, Sweden

关键词: Pupils;    Accelerometers;    School yard;    Physical activity;    Outdoor environment;   

Others  :  1128774
DOI  :  10.1186/1471-2458-14-803

 received in 2014-03-20, accepted in 2014-07-31,  发布年份 2014

【 摘 要 】

Background

School children are confined to and exposed to outdoor environment that happens to be at their disposal during compulsory school time. The health-promoting potential of outdoor environment, and the use of it, is therefore important. We have studied the impact of school outdoor environment in terms of playground features, space, topography and vegetation upon the patterns of moderate to vigorous physical activity (MVPA) across ages and seasons in Swedish pupils at compulsory school.

Methods

Four schools in the Middle and Southern parts of Sweden, with outdoor environments differing in playground features, space, topography and vegetation were analyzed during one school year. A sample of 196 children was drawn from eligible pupils in grades 2, 5 and 8, aged 7–14 years. PA was monitored with time-stamped Actigraph accelerometers GT3X+, measuring different intensity levels during outdoor time. Maps were used to mark places where the children stayed and what they did during outdoor time.

Results

Mean MVPA during outdoor stay was 39 minutes for the entire school year, time in MVPA correlated positively with outdoor time, as did MVPA with used outdoor play area (p < 0.001). Outdoor MVPA declined with age, boys accumulated more MVPA than girls at all ages (p < 0.001). Ball play areas increased MVPA in 5^th graders in September and May (p < 0.001). Overall, ball play areas increased 5^th graders’ relative MVPA, and helped maintaining it with increasing age in boys but not in girls, whereas woodland stimulated and contributed to maintaining girls’ MVPA with increasing age. Outdoor temperature significantly impacted (p < 0.01) MVPA throughout all seasons.

Conclusion

We conclude that school outdoor environment design and outdoor play time impact physical activity on a daily basis and may contribute to increasing girls’ physical activity and moderate the sharp decline in physical activity by age. The school outdoor environment may thus be a potential health promoter during school time.

【 授权许可】

   
2014 Pagels et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Strong WB, Malina RM, Blimkie CJ, Daniels SR, Dishman RK, Gutin B, Hergenroeder AC, Must A, Nixon PA, Pivarnik JM, Rowland T, Trost S, Trudeau F: Evidence based physical activity for school-age youth. J Pediatr 2005, 146(6):732-737.
• [2]Janssen I, Leblanc AG: Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int J Behav Nutr Phys Activ 2010, 7:40.
• [3]Martensson F, Boldemann C, Soderstrom M, Blennow M, Englund JE, Grahn P: Outdoor environmental assessment of attention promoting settings for preschool children. Health Place 2009, 15(4):1149-1157.
• [4]Sakuragi S, Abhayaratna K, Gravenmaker KJ, O'Reilly C, Srikusalanukul W, Budge MM, Telford RD, Abhayaratna WP: Influence of adiposity and physical activity on arterial stiffness in healthy children: the lifestyle of our kids study. Hypertension 2009, 53(4):611-616.
• [5]de Onis M, Blossner M, Borghi E: Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr 2010, 92(5):1257-1264.
• [6]Herouvi D, Karanasios E, Karayianni C, Karavanaki K: Cardiovascular disease in childhood: the role of obesity. Eur J Pediatr 2013, 172(6):721-732.
• [7]Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S: Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004, 350(23):2362-2374.
• [8]Lemanne D, Cassileth B, Gubili J: The role of physical activity in cancer prevention, treatment, recovery, and survivorship. Oncology 2013, 27(6):580-585.
• [9]Aggoun Y: Obesity, metabolic syndrome, and cardiovascular disease. Pediatr Res 2007, 61(6):653-659.
• [10]Berenson GS, Srinivasan SR, Bao W, Newman WP 3rd, Tracy RE, Wattigney WA: Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998, 338(23):1650-1656.
• [11]Blair SN, LaMonte MJ: How much and what type of physical activity is enough? What physicians should tell their patients. Arch Intern Med 2005, 165(20):2324-2325.
• [12]Owen CG, Nightingale CM, Rudnicka AR, Cook DG, Ekelund U, Whincup PH: Ethnic and gender differences in physical activity levels among 9-10-year-old children of white European, South Asian and African-Caribbean origin: the Child Heart Health Study in England (CHASE Study). Int J Epidemiol 2009, 38(4):1082-1093.
• [13]Steele RM, van Sluijs EM, Cassidy A, Griffin SJ, Ekelund U: Targeting sedentary time or moderate- and vigorous-intensity activity: independent relations with adiposity in a population-based sample of 10-y-old British children. Am J Clin Nutr 2009, 90(5):1185-1192.
• [14]Trost SG, Pate RR, Sallis JF, Freedson PS, Taylor WC, Dowda M, Sirard J: Age and gender differences in objectively measured physical activity in youth. Med Sci Sports Exerc 2002, 34(2):350-355.
• [15]Dessing D, Pierik FH, Sterkenburg RP, van Dommelen P, Maas J, de Vries SI: School yard physical activity of 6–11 year old children assessed by GPS and accelerometry. Int J Behav Nutr Phys Activ 2013, 10:97.
• [16]Griew P, Page A, Thomas S, Hillsdon M, Cooper AR: The school effect on children’s school time physical activity: the PEACH Project. Prev Med 2010, 51(3–4):282-286.
• [17]Sallis JF, Saelens BE: Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exerc Sport 2000, 71(2 Suppl):S1-S14.
• [18]Ferreira I, van der Horst K, Wendel-Vos W, Kremers S, van Lenthe FJ, Brug J: Environmental correlates of physical activity in youth - a review and update. Obes Rev 2007, 8(2):129-154.
• [19]Baranowski T, Thompson WO, DuRant RH, Baranowski J, Puhl J: Observations on physical activity in physical locations: age, gender, ethnicity, and month effects. Res Q Exerc Sport 1993, 64(2):127-133.
• [20]Sallis JF, McKenzie TL, Alcaraz JE: Habitual physical activity and health-related physical fitness in fourth-grade children. Am J Dis Child 1993, 147(8):890-896.
• [21]Beighle A, Morgan CF, Le Masurier G, Pangrazi RP: Children’s physical activity during recess and outside of school. J Sch Health 2006, 76(10):516-520.
• [22]Raustorp A, Pagels P, Boldemann C, Cosco N, Soderstrom M, Martensson F: Accelerometer measured level of physical activity indoors and outdoors during preschool time in Sweden and the United States. J Phys Act Health 2012, 9(6):801-808.
• [23]Soderstrom M, Boldemann C, Sahlin U, Martensson F, Raustorp A, Blennow M: The quality of the outdoor environment influences childrens health – a cross-sectional study of preschools. Acta Paediatr 2013, 102(1):83-91.
• [24]Cardon G, Van Cauwenberghe E, Labarque V, Haerens L, De Bourdeaudhuij I: The contribution of preschool playground factors in explaining children’s physical activity during recess. Int J Behav Nutr Phys Activ 2008, 5:11.
• [25]Sallis JF, Conway TL, Prochaska JJ, McKenzie TL, Marshall SJ, Brown M: The association of school environments with youth physical activity. Am J Public Health 2001, 91(4):618-620.
• [26]Ridgers ND, Fairclough SJ, Stratton G: Twelve-month effects of a playground intervention on children’s morning and lunchtime recess physical activity levels. J Phys Act Health 2010, 7(2):167-175.
• [27]Haug E, Torsheim T, Sallis JF, Samdal O: The characteristics of the outdoor school environment associated with physical activity. Health Educ Res 2010, 25(2):248-256.
• [28]Mårtensson F, Jansson M, Johansson M, Raustorp A, Kylin M, Boldemann C: The role of greenery for physical activity play at school grounds. Urban Forestry & Urban Greening 2014, 13(1):103-113.
• [29]Tucker P, Gilliland J: The effect of season and weather on physical activity: a systematic review. Public Health 2007, 121(12):909-922.
• [30]Rowlands AV, Hughes DR: Variability of physical activity patterns by type of day and season in 8-10-year-old boys. Res Q Exerc Sport 2006, 77(3):391-395.
• [31]Rowlands AV, Pilgrim EL, Eston RG: Seasonal changes in children’s physical activity: an examination of group changes, intra-individual variability and consistency in activity pattern across season. Ann Hum Biol 2009, 36(4):363-378.
• [32]Tudor-Locke C, Lee SM, Morgan CF, Beighle A, Pangrazi RP: Children’s pedometer-determined physical activity during the segmented school day. Med Sci Sports Exerc 2006, 38(10):1732-1738.
• [33]Ridgers ND, Salmon J, Parrish AM, Stanley RM, Okely AD: Physical activity during school recess: a systematic review. Am J Prev Med 2012, 43(3):320-328.
• [34]Fjørtoft IK B, Sageie J: Children in school yards: tracking movement patterns and physical activity in school yards using global positioning system and heart rate monitoring. Landscape and Urban Planning 2009, 93(3–4):210-217.
• [35]McClain JJ, Abraham TL, Brusseau TA Jr, Tudor-Locke C: Epoch length and accelerometer outputs in children: comparison to direct observation. Med Sci Sports Exerc 2008, 40(12):2080-2087.
• [36]Baquet G, Stratton G, Van Praagh E, Berthoin S: Improving physical activity assessment in prepubertal children with high-frequency accelerometry monitoring: a methodological issue. Prev Med 2007, 44(2):143-147.
• [37]Trost SG, Loprinzi PD, Moore R, Pfeiffer KA: Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc 2011, 43(7):1360-1368.
• [38]Tandon PS, Saelens BE, Zhou C, Kerr J, Christakis DA: Indoor versus outdoor time in preschoolers at child care. Am J Prev Med 2013, 44(1):85-88.
• [39]Flynn JI, Coe DP, Larsen CA, Rider BC, Conger SA, Bassett DR Jr: Detecting indoor and outdoor environments using the ActiGraph GT3X+ light sensor in children. Med Sci Sports Exerc 2014, 46(1):201-206.
• [40]Sherar LB, Esliger DW, Baxter-Jones AD, Tremblay MS: Age and gender differences in youth physical activity: does physical maturity matter? Med Sci Sports Exerc 2007, 39(5):830-835.
• [41]Guinhouya BC, Samouda H, de Beaufort C: Level of physical activity among children and adolescents in Europe: a review of physical activity assessed objectively by accelerometry. Public Health 2013, 127(4):301-311.
• [42]Silva P, Santos R, Welk G, Mota J: Seasonal Differences in Physical Activity and Sedentary Patterns: The Relevance of the PA Context. J Sports Sci Med 2011, 10(1):66-72.
• [43]Kolle E, Steene-Johannessen J, Andersen LB, Anderssen SA: Seasonal variation in objectively assessed physical activity among children and adolescents in Norway: a cross-sectional study. Int J Behav Nutr Phys Activ 2009, 6:36.
• [44]Boldemann C, Blennow M, Dal H, Martensson F, Raustorp A, Yuen K, Wester U: Impact of preschool environment upon children’s physical activity and sun exposure. Prev Med 2006, 42(4):301-308.
• [45]Belanger M, Gray-Donald K, O'Loughlin J, Paradis G, Hanley J: Influence of weather conditions and season on physical activity in adolescents. Ann Epidemiol 2009, 19(3):180-186.
• [46]Feinglass J, Lee J, Semanik P, Song J, Dunlop D, Chang R: The effects of daily weather on accelerometer-measured physical activity. J Phys Act Health 2011, 8(7):934-943.