Regional Socioeconomic Deprivation in Germany and Adherence to the 24-h Movement Guidelines among Children and Adolescents.

To examine the relationship between regional socioeconomic deprivation and adherence to the 24-h movement guidelines among children and adolescents, a cross-sectional study was conducted. A total of 17,433 students aged 9-17 participated in a survey in winter 2021/2022. Daily screen time (ST), moderate-to-vigorous physical activity (MVPA), and sleep behavior were outcome variables. The German Index of Socioeconomic Deprivation (GISD), a regional socioeconomic objective measure, was the exposure variable. Associations between GISD and health behaviors were examined using regression models. Models were adjusted for age, gender, school type, and individual self-reported socioeconomic status (SES). The proportions of meeting the MVPA, ST, and sleep duration guidelines were 14%, 22%, and 34%, respectively. A total of 2.3% met all guidelines. Students from the most deprived communities were half as likely to meet all three guidelines compared to students from the most affluent regions (OR = 0.49 [0.28; -0.03], p = 0.010). There was a consistent relationship between GISD and lower levels of adherence to screen time guidelines (most deprived compared to most affluent: OR = 0.49 [0.38; 0.64], p < 0.001). There was no association between GISD and adherence to sleep time guidelines. We found mixed results for the association between GISD and MVPA. Regional SES appears to be an important factor associated with screen time. Screen time should be limited through intervention programs, especially in disadvantaged areas. Parents should be made aware of their children's increased media consumption. Recommendations for screen time should be clearly communicated, as should the health disadvantages of increased media consumption in childhood and adolescence.

Effects of a School-Based Pedometer Intervention in Adolescents: 1-Year Follow-Up of a Cluster-Randomized Controlled Trial.

BACKGROUND: Physical activity (PA) is one of the most important health behaviors that may be modified by each individual. To foster PA in adolescents, a school-based intervention was evaluated. METHODS: A cluster-randomized controlled trial with preassessment in 2014 and follow-up assessment in 2015 included 29 schools with 1020 students (47.6% girls, mean age = 13.69 years). Intervention students received pedometers and monitored their steps for 12 weeks. Classes with the most steps were awarded. Primary outcomes included moderate-to-vigorous PA, out-of-school sports activities, active transport assessed through questionnaires, as well as cardiorespiratory fitness measured using the 20-m shuttle-run test and anthropometric data (weight, height, body fat, and waist circumference) assessed by study staff. RESULTS: Significant interaction terms between group and time were found for all 3 indicators of PA; intervention students showed a higher increase of PA than control students. The same pattern was shown for cardiorespiratory fitness, but the effect missed significance. A more favorable development for the intervention students was shown for body fat and waist-to-height ratio, while there was no effect on body mass index percentile. CONCLUSIONS: An easy way to administer school-based PA program may enhance students' leisure-time PA even 1 year after the intervention has ended.

Motivational Aspects and Critical Issues of a Pedometer Intervention in Adolescents.

BACKGROUND: Existing research shows significant effects of pedometer interventions on students' physical activity (PA). The current study investigates motivational aspects of quantitative increases in PA in the course of a school-based pedometer intervention for adolescents using qualitative data analysis. In addition, critical issues regarding pedometer use in adolescence were examined. METHOD: Data were obtained in the "läuft." evaluation trial. Students of the intervention group received pedometers and took part in class competitions over a time period of 12 weeks. Qualitative data were collected through focus groups (n = 34) with students of the intervention group as well as through in-depth interviews with teachers (n = 33) who implemented the intervention. A grounded theory approach was used to analyze qualitative data. RESULTS: Five major motivational aspects for subsequent increases in PA were examined among students participating in the "läuft." PA program issues: (1) affordance of the pedometer, (2) awareness of the own PA, (3) self-determination with regard to time and type of PA, (4) individual goal setting, and (5) social comparison and competition. CONCLUSIONS: Findings provide a deeper understanding of which aspects of pedometer interventions might be especially important in adolescence and help design effective future interventions for the promotion of PA.

Relationship between attention-deficit/hyperactivity disorder and sedentary behavior in adolescence: a cross-sectional study.

Existing studies reveal that high levels of sedentary behavior are associated with more inattention and hyperactivity problems. Since most previous studies used screen time as an indicator of sedentary behavior and assessed symptoms of attention-deficit/hyperactivity disorder (ADHD) by short screening measures which do not allow to distinguish between subtypes of ADHD, the current study aimed to investigate association between different types of sedentary behavior and symptoms and subtypes of ADHD. The current cross-sectional study analyzed data of 913 students (46.1% girls) aged 13-17 years (M = 15.0, SD = 0.6). Using a self-administered questionnaire, screen-based and non-screen-based sedentary behavior and ADHD symptoms were assessed. Linear and logistic regression analyses were conducted. All analyses were adjusted for age, gender, moderate to vigorous physical activity and body mass index. Screen time was related to the total ADHD score (p < 0.001) as well as to the subscales inattention (p ≤ 0.016) and hyperactivity/impulsivity (p ≤ 0.008). Sedentary time without screens was virtually not associated with ADHD. As far as ADHD symptoms are considered as a correlate of sedentary behavior, the type of activity which is pursued sedentarily seems to matter: screen time, but not other non-screen-based sedentary activities should be considered as being a risk factor for ADHD.

Longitudinal Relationships of Fitness, Physical Activity, and Weight Status With Academic Achievement in Adolescents.

BACKGROUND: To examine associations of cardiorespiratory fitness, physical activity (PA) and weight status with academic achievement 1 year later. In addition, the mediating role of psychological variables was tested. METHODS: Longitudinal analyses included 1011 German students (M = 14.1 years, SD = 0.6 years). Cardiorespiratory fitness was determined with the 20 m shuttle run test. Compliance with PA guidelines was assessed through questionnaire. Weight status was based on body mass index percentiles. As proxy of academic achievement students' self-reported grades in Mathematics and German in their midterm report were averaged. Mediation analyses were conducted at follow-up testing general self-efficacy, depressed affect, and attention/hyperactivity problems. RESULTS: High levels of cardiorespiratory fitness predicted higher educational attainment (p = .007), while we found no longitudinal association for PA and weight status (p > .253). However, students being insufficiently physically active at baseline but meet PA guidelines at follow-up showed a significant improvement in educational attainment. The cross-sectional association between PA and academic achievement was mediated by students' general self-efficacy. CONCLUSION: High fitness in adolescence is associated with higher subsequent academic achievement. The promotion of PA might benefit school performance because of enhanced fitness levels in the long-term and positive influences of PA in the shortterm. The association between weight status and educational attainment remains controversial.

[Sedentary Behavior and the health of adolescents]. / Sitzendes Verhalten und die Gesundheit Jugendlicher.

BACKGROUND: In modern societies, adolescents spend about half of their waking hours with sedentary behavior (SB). Therefore, the current study aims at investigating the relationship between SB and adolescents' health. METHODS: A cross-sectional sample of 1296 students (8(th) grade) from 29 schools in Schleswig-Holstein, Germany was surveyed. Mean age was 13.75 years (SD = 0.67), 47.0 % were female. To asses screen-based and non-screen-based SB, moderate to vigorous physical activity as well as further indicators of health behavior (tobacco and alcohol use, diet) a questionnaire was used. Anthropometric data and blood pressure at rest were assessed during a medical testing and cardiorespiratory fitness was assessed by the 20 m-Shuttle-Run-Test. RESULTS: The students spent almost 7 hours a day sedentary. Total SB was positively associated with behavior that is detrimental to health. These associations were detectable only for screen-based SB, not for non-screen-based SB. Cardiorespiratory fitness was associated negatively with total SB, screen-based as well as non-screen-based SB. Associations remained widely stable when moderate to vigorous physical activity was controlled for. There were almost no associations between SB and blood pressure. DISCUSSION: Total SB, but especially screen-based SB seems to be a health risk factor in adolescence independent of physical activity. Besides fostering physical activity, reduction of SB should be a core target behavior in prevention and health promotion.

Screen time, weight status and the self-concept of physical attractiveness in adolescents.

Adolescents in modern societies spend about 3 h per day in front of small recreational screens. The present study aims at investigating the relationships between screen time and different indicators of overweight. In addition, associations with the self-concept of physical attractiveness and perceived weight status will be examined. In a total sample of 1228 students (47.5% girls) aged 12-17 years (M = 13.74, SD = 0.68) cross-sectional associations were determined by conducting multiple linear regression analyses. Screen time showed a significant positive dose-response relationship with body mass index percentile, waist circumference, body fat, waist-to-height-ratio, and a negative association with self-concept of physical attractiveness independent of age, gender and moderate to vigorous physical activity. Thus, screen time seems to be associated with adolescent overweight, abdominal obesity, and body dissatisfaction. Reducing adolescents' screen time could be a promising approach for primary prevention of obesity and for the promotion of a positive physical self-concept.

Prospective effects of pedometer use and class competitions on physical activity in youth: A cluster-randomized controlled trial.

OBJECTIVE: To evaluate the immediate effects of a school-based multi-component program to foster a physically active lifestyle in adolescence. DESIGN/PARTICIPANTS: In a cluster-randomized controlled trial with pre- and post-assessment in 2014, 29 schools with 1162 8th grade students (48% girls) from Germany were included. Age ranged from 12 to 17 years (M=13.74; SD=0.67). INTERVENTION: While the control group attended education as usual, students in the intervention group received pedometers and took part in a class competition over a time period of 12 weeks. Classes with the most steps and best creative ideas to promote physical activity in everyday life were awarded. MAIN OUTCOME MEASURES: Primary outcomes included out-of-school sports activities (h/week), moderate to vigorous physical activity (days/week with a minimum of 60 min), active commuting (min/day), doing chores (min/day), and sedentary behavior (h/day) assessed through self-administered questionnaires as well as cardiorespiratory fitness measured using the 20-m shuttle-run test (completed laps). RESULTS: Significant interaction terms between group and wave of assessment were found on out-of-school sports activities (b=-1.09 [-1.89; -0.29], p=0.008), moderate to vigorous physical activity (b=-0.29 [-0.47; -0.10], p=0.002), and active commuting (b=-20.41 [-32.32; -8.49], p=0.001): students in the intervention group showed a higher increase of physical activity levels than students in the control group. The intervention effect on cardiorespiratory fitness missed significance marginally (b=-1.52 [-3.14; 0.98], p=0.065), There was no effect on students' sedentary behavior (b=0.06 [-0.72; 0.84], p=0.881). CONCLUSIONS: An easy to administer school-based physical activity program (12 weeks) may enhance students' leisure-time physical activity. TRIAL REGISTRATION NUMBER: ISRCTN49482118.

Sedentary behavior and indicators of mental health in school-aged children and adolescents: A systematic review.

OBJECTIVE: The presented systematic review aims at giving a comprehensive overview of studies assessing the relationship between sedentary behavior and indicators of mental health in school-aged children and adolescents. METHODS: Six online databases (MEDLINE, EMBASE, PsycINFO, PsycARTICLES, CINAHL and SPORTDiscus) as well as personal libraries and reference lists of existing literature were searched for eligible studies. RESULTS: Ninety-one studies met all inclusion criteria. There was strong evidence that high levels of screen time were associated with more hyperactivity/inattention problems and internalizing problems as well as with less psychological well-being and perceived quality of life. Concerning depressive symptoms, self-esteem, eating disorder symptoms, and anxiety symptoms, no clear conclusion could be drawn. But, taking quality assessment into account, self-esteem was negatively associated with sedentary behavior, i.e. high levels of time engaging in screen-based sedentary behavior were linked to lower scores in self-esteem. CONCLUSIONS: Overall, the association between sedentary behavior and mental health indicators was rather indeterminate. Future studies of high quality and with an objective measure of sedentary behavior will be necessary to further examine this association as well as to investigate longitudinal relationships and the direction of causality. Furthermore, more studies are needed to identify moderating and mediating variables.

Sedentary behavior, depressed affect, and indicators of mental well-being in adolescence: Does the screen only matter for girls?

The study investigated the effects of sedentary behavior (SB) on mental well-being and examined differences between screen-based (sSB) and non-screen-based sedentary behaviors (nSB) separately by gender. In a total sample of 1296 students (609 girls) aged 12-17 (m = 13.7, SD = 0.67), SB, depressed affect, self-esteem, physical self-concept, general self-efficacy and physical activity were assessed through self-administered questionnaires. Among girls, lower scores in self-esteem, physical self-concept as well as general self-efficacy were associated with higher sSB but not nSB. Among boys higher levels of sSB related to higher self-esteem, nSB but not sSB predicted higher scores in depressed affect, and there was a u-shaped association between sSB and general self-efficacy. Results replicate the inverse association between SB and mental well-being, and suggest a distinction between nSB and sSB especially among girls. Additional studies will be necessary to replicate, and further examine mediating mechanisms.

Threatening shapes: the impact of simple geometric configurations on peripheral physiological markers.

The fast and reliable neuronal and behavioral responses to negative affective stimuli have been suggested to be at least partly based on the processing of simple geometric configurations within complex visual stimuli. In this context, one line of experimental and neuroimaging evidence suggests that simple V-shaped stimuli result in patterns of neuronal activation and behavioral responses akin to pictures of negative facial expressions. The present study investigated the effects of circles as well as upward and downward pointing triangles in healthy young adults on three peripheral physiological markers - skin conductance response (SCR), facial EMG, and startle reflex - in order to further narrow the gap between neuroimaging findings and behavioral data regarding the impact of geometric shapes. We found significant effects of geometric forms on the startle reflex (p≤0.001, η(2)=0.080) and the SCR (p=0.029, η(2)=0.078), but not on facial EMG. Furthermore, subjective valence and arousal ratings of geometric stimuli differed significantly, with downward pointing triangles being perceived as less pleasant and more arousing. In sum, our findings provide further evidence that simple geometric shapes convey emotional meaning. Particularly, the observed changes in SCR and startle response underscore the notion that geometric shapes lead to preparatory changes in physiological activation patterns, which are essential for facilitation of appropriate behavioral responses. However, the smaller effect sizes compared to more realistic affective pictures also highlight the organisms' ability to differentiate between real impending danger and abstract cues in order to avoid unnecessary excessive responses.

"läuft."--a school-based multi-component program to establish a physically active lifestyle in adolescence: study protocol for a cluster-randomized controlled trial.

BACKGROUND: Physical activity during childhood and adolescence is associated with substantial health benefits and tracks into adulthood. Nevertheless, only 22.7% of German adolescents are sufficiently physically active. Thus, the promotion of an active lifestyle in youth is an essential issue of public health.This study will evaluate the implementation and efficacy of the "läuft." program to enhance physical activity in adolescence. "läuft." is a multicomponent school-based program developed on the basis of effective strategies for health interventions and behavioral change. METHODS/DESIGN: The "läuft." physical activity program targets four different levels. (a) Each student receives a pedometer and documents his/her steps over 12 weeks using an interactive user account on the "läuft." homepage. (b) For classes there will be different competitions, with achieving the most steps in selected weeks, the highest increases of steps and developing the most inventive ideas to promote physical activity in school. Besides, the intervention includes four educational lessons. (c) The headmasters and teaching staff of the participating schools will get information material with suggestions and encouragement to enhance physical activity in school. Participating teachers will be invited to an introductory seminar. (d) Parents will be provided with informational material about the program and will be invited to a parent-teacher conference about the benefits of being physically active and how they can support their children in engaging in a physically active lifestyle.To evaluate the efficacy of the "läuft." physical activity program, a two-arm cluster randomized controlled trial will be conducted in three waves: (1) baseline assessment, January/February 2014, (2) post assessment, June/July 2014 and (3) 12-month follow-up assessment, June/July 2015. Data collection will include physical and medical testing, self-administered questionnaires, group discussions and document analyses. DISCUSSION: "läuft." aims at fostering a physically active lifestyle in adolescence while a considerable decline of physical activity is present. Physical activity programs based in the school setting and following a multicomponent approach have been proven to be most successful. Furthermore, the use of pedometers is promising to enhance physical activity during the entire day and targets a wide range of adolescents regarding fitness and weight. TRIAL REGISTRATION: Current Controlled Trials ISRCTN49482118.