The geospatial and conceptual configuration of the natural environment impacts the association with health outcomes and behavior in children and adolescents.

BACKGROUND: Studies investigating associations between natural environments and health outcomes or health behaviors in children and adolescents yielded heterogenous results to date. This may be the result of different geospatial configurations of the natural environment and confounding characteristics of the study population. Thus, we investigated how the relationship between the natural environment and mental health, muscular fitness, and physical activity varies depending on the geospatial configuration of nature and children's and adolescents' characteristics. METHODS: Data were derived from the German Motorik-Modul (MoMo) cohort study (2018-2020) that investigates physical activity, muscular fitness, and health parameters in a national sample of children and adolescents (N = 2843) between four and 17 years (Mage = 10.46 ± 3.49 years; 48.3% girls). Mental health was assessed via questionnaire, muscular fitness via standing long jump, and physical activity with 7-day accelerometer measurement. Using geographic information systems, land cover, and land use data, three different nature definitions were applied. Both circular buffers (100-1000 m) and street-network buffers (1000-5000 m) were created for each of the nature definitions. Associations were explored with linear regression models, and interaction analysis was used to investigate how those relationships vary by gender, age, and socio-economic status. RESULTS: The relationship between the three outcomes and the natural environment varied considerably depending on the nature definition, buffer size, and buffer type, as well as socio-demographic characteristics. Specifically, when comparing youth with a high socio-economic status to those with a medium socio-economic status, smaller circular buffer distances were related to less physical activity, but larger street-network buffer distances were related to greater mental health problems. Distinct relationships also occurred for youth with low socio-economic status in those relationships, with the pattern being less clear. CONCLUSIONS: For future health research studies that investigate the role of the natural environment, we argue for the development of an a-priori model that integrates both geospatial considerations (nature definition, buffer type, and buffer size) and conceptual considerations (health outcome/behavior, sample characteristics) based on potentially underlying mechanisms that link the natural environment and the health outcome or behavior under investigation to theoretically underpin the geospatial configuration of the natural environment.

Changes in Physical Fitness during the COVID-19 Pandemic in German Children.

With the beginning of the COVID-19 pandemic in December 2019, each country has developed strategies to try to control the virus. The restrictions and subsequent consequences also limited the possibilities and structures for being physically active. Therefore, the aim of this study was to examine changes in physical fitness in a cohort that was investigated over an extended period. Physical fitness testing was conducted with the IPPTP-R in a primary school from a small rural community annually since 2012. Mean values of test items were calculated for each cohort. We conducted an ANCOVA to examine the differences between cohorts PreCOVID and 2020 as the first year of the COVID-19 pandemic, and between PreCOVID and 2021 as the second year of the COVID-19 pandemic. Overall, no evidence for a negative effect of the COVID-19 pandemic on physical fitness in children between the ages of 7 and 9 years was found. In strength tests, performances increased when comparing the PreCOVID cohort and COVID-19 cohorts (Push-Ups: p < 0.001, ηp2 = 0.032; p = 0.017, ηp2 = 0.006). No evidence for a change was found for endurance (6-min Run: p = 0.341, ηp2 = 0.001; p = 0.267, ηp2 = 0.001. The rural community maintained physical fitness despite restrictions and limitations through the environmental circumstances. Considering this, it is a positive example of how adequate long-term efforts promoting physical fitness make an impact and an active friendly environment helps to overcome COVID-19 pandemics limiting the structures for being physically active.

Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis.

With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population.

The Fitness Barometer: A Best Practice Example for Monitoring Motor Performance With Pooled Data Collected From Practitioners.

Introduction: Motor Performance (MP) in children is an important resource for their future active lifestyle and health. Monitoring of MP is crucial to derive information of trends and to implement specific programs on the base of current MP levels. A variety of MP assessment tools exist, making it difficult to determine a "gold-standard" for assessment and to compare the findings. In Germany, the German Motor Test 6-18 (GMT 6-18) and Kinderturntest Plus 3-10 (KITT+ 3-10) are widely used MP assessment tools. The aim of this paper is to show which key questions can be answered within the context of a best practice example of a MP assessment tool and what can be derived from this for a practical application (the Fitness Barometer). Methods: The raw data of the Fitness Barometer was collected with the MP assessment tools GMT 6-18 and KITT+ 3-10 from 2012 through 2020. Data was pooled anonymously with the e-Research infrastructure MO|REdata and categorized into percentiles for MP and BMI. Overall, we included data of 23,864 children for the statistical analyses. T-tests for independent samples, percentage frequency analysis, descriptive statistics (chi- square-test) and single analysis of variance were conducted. Results and Discussion: Children tested reached a mean value of 57.03 (SD = 18.85). Of the sample, 12.7% children were overweight or obese and there is a significant difference between age groups [ χ(4)2 = 178.62, p < 0.001, Cramer V = 0.09; n = 23.656]. The relationship between BMI category and mean value of MP was significant [F(4,19,523) = 224.81, p < 0.001]. During 2020, the year of the COVID-19 pandemic, mean value of endurance and speed decreased [Welch's F(1,573) = 8.08, p = 0.005; Welch's F(1,610) = 35.92, p < 0.001]. The GMT 6-18 and KITT+ 3-10 are valid, objective, reliable, and economic MP assessment tools for monitoring MP levels and derive added practical value. Specific programs and interventions should focus on the findings of these. The Fitness Barometer is a best practice example how a standardized assessment tool of monitoring MP point to trends on which practical evidence-based suggestions can be derived with many various partners and expertise.

Influence of socioeconomic variables on physical activity and screen time of children and adolescents during the COVID‑19 lockdown in Germany: the MoMo study Einfluss sozioökonomischer Variablen auf die körperlich-sportliche Aktivität und Bildschirmmediennutzung von Kindern und Jugendlichen während des COVID‑19-Lockdowns in Deutschland: die MoMo-Studie

The COVID‑19 (coronavirus disease 2019) pandemic created a multitude of natural experiments about the change of human behavior in a widely unfamiliar situation. Besides physical and mental health, physical activity (PA) and people’s movement behaviors were of particular interest to researchers all over the world. In a recent study, we found that among youth in Germany, sports activity declined, whereas recreational screen time and habitual activity increased during the first COVID‑19 lockdown. In the present study, we analyze the influence of the socioeconomic status and the housing situation on the changes in PA behavior and recreational screen-time before and during the first COVID‑19 lockdown among children and adolescents living in Germany. We found an alignment of PA behavior among youth from families with different socioeconomic backgrounds during the first lockdown and identified the housing situation to be a meaningful predictor of the increase in habitual activity. We conclude that restriction policies, communities, and in the last instance parents need to enable access to nonorganized PA to all children and adolescents every day and especially during potential future lockdowns.

Influence of socioeconomic variables on physical activity and screen time of children and adolescents during the COVID‑19 lockdown in Germany: the MoMo study

The COVID‑19 (coronavirus disease 2019) pandemic created a multitude of natural experiments about the change of human behavior in a widely unfamiliar situation. Besides physical and mental health, physical activity (PA) and people’s movement behaviors were of particular interest to researchers all over the world. In a recent study, we found that among youth in Germany, sports activity declined, whereas recreational screen time and habitual activity increased during the first COVID‑19 lockdown. In the present study, we analyze the influence of the socioeconomic status and the housing situation on the changes in PA behavior and recreational screen-time before and during the first COVID‑19 lockdown among children and adolescents living in Germany. We found an alignment of PA behavior among youth from families with different socioeconomic backgrounds during the first lockdown and identified the housing situation to be a meaningful predictor of the increase in habitual activity. We conclude that restriction policies, communities, and in the last instance parents need to enable access to nonorganized PA to all children and adolescents every day and especially during potential future lockdowns.

Population density predicts youth's physical activity changes during Covid-19 - Results from the MoMo study.

Children in Germany showed positive physical activity changes during the first Covid-19 lockdown in April 2020, but it is unclear how the changes relate to population density, which we investigated in a longitudinal sample of 1711 youth (4-17 years). For each ten citizens more per km2, less positive physical activity changes were observed. For example, a child living in an area with 100 citizens/km2 increased daily life physical activity by 44.50 min/day, whereas a child living in an area with 3000 citizens/km2 only engaged in an additional 9.70 min/day. Policymakers should ensure that youth in densely populated areas have access to physical activity opportunities during the pandemic.

Reply to Kersting et al. Comment on "Wunsch et al. The Impact of COVID-19 on the Interrelation of Physical Activity, Screen Time and Health-Related Quality of Life in Children and Adolescents in Germany: Results of the Motorik-Modul Study. Children 2021, 8, 98".

In reply to the comment of Kersting et al [...].

The Impact of COVID-19 on the Interrelation of Physical Activity, Screen Time and Health-Related Quality of Life in Children and Adolescents in Germany: Results of the Motorik-Modul Study.

Reduced physical activity (PA) and prolonged screen time (ST) negatively influence health-related quality of life (HRQoL), a protective factor against illness and mortality. Studies addressing the relationship between PA, ST, and mental health in youth are scarce, especially in times with high mental health burdens like the COVID-19 pandemic. The purpose of this examination was to investigate whether PA, ST, and HRQoL before COVID-19 predict PA, ST, and HRQoL during the COVID-19 pandemic. Participants from the Motorik-Modul Study (MoMo; N = 1711; Mage = 10.36 (SD = 4.04) years, female = 49.8%; healthy weight = 76.8%) self-reported their PA and ST as well as HRQoL both before and during COVID-19. Relationships of all variables, from before to during COVID-19, were investigated through a path prediction model. Results showed all variables during COVID-19 were predicted by the respective levels before COVID-19, independent of gender and age. Cross-lags revealed a negative influence of before COVID-19 ST on during COVID-19 PA. HRQoL before COVID-19 was positively associated with during COVID-19 PA in children younger than 10 years and females, but not in adolescents and boys. As age- and gender-independent negative influence of before COVID-19 ST on during COVID-19 PA has been detected, health policy may be advised to focus on a general reduction in ST instead of PA enhancement to ensure high PA levels.

Physical activity and screen time of children and adolescents before and during the COVID-19 lockdown in Germany: a natural experiment.

The impact of COVID-19 on social life has been drastic and global. However, the different numbers of cases and different actions in different countries have been leading to various interesting yet unexplored effects on human behavior. In the present study, we compare the physical activity and recreational screen time of a representative sample of 1711 4- to 17-year-olds before and during the strictest time of the first COVID-19 lockdown in Germany. We found that sports activity declined whereas recreational screen time increased. However, a substantial increase in habitual physical activities leads to an overall increase in physical activity among children and adolescents in Germany. The effects differ in size but not in their direction between age groups and are stable for boys and girls. We conclude from this natural experiment that physical activity among children and adolescents is highly context-driven and mutual and does not act as a functional opposite to recreational screen time.