Programme Leader – Dr Esther van Sluijs
Physical activity during childhood is important for both contemporary and future health. Evidence suggests that young people’s levels of physical activity are insufficient for health. More importantly, physical activity on average declines with age. Identifying ways to maintain and, where applicable, promote physical activity in young people is therefore a key public health issue.
Physical activity is a complex behaviour, influenced by a combination of factors from multiple ecological levels, including individual, socio-cultural, policy and environmental-level factors. The relative importance of these factors and how they interact is still largely unknown. Moreover, our current understanding is largely based on cross-sectional evidence, limiting our ability to draw conclusions about causality and inform intervention development.
Our work on physical activity in young people is set in the socio-ecological model and guided by the Behavioural Epidemiology framework, which proposes a systematic sequence of studies leading to evidence-based interventions directed at populations.
The Behavioural Epidemiology programme aims to develop and evaluate interventions to change young people’s activity behaviour through a thorough understanding of the patterns, consequences, correlates and determinants of the behaviour of interest.
The work of programme broadly covers two main themes:
1. Understanding the patterns and determinants of physical activity and dietary behaviour in young people
Our efforts focus on quantitative analyses of patterns of and factors influencing change in physical activity in different age groups and across different transitions throughout childhood (e.g. from preschool into primary school, from primary into secondary school, and into adulthood). This programme is also studying associations between physical activity behaviours and non-physical health outcomes (e.g. psychological health and academic performance), and patterns and determinants of dietary behaviour, particularly over the transition to adulthood.
The study of characteristics of physical activity and dietary behaviour, and how it changes, is crucial to understanding when and where interventions may be targeted and what specific behaviours should be considered. Most of the existing evidence is limited by the cross-sectional nature of the data available. This makes it impossible to start understanding the cause-and-effect relationship between variables. In this programme, we aim to study the predictors of behaviour change in young people. Using data from in children from different ages (SWS, SPEEDY, ROOTS), we are establishing the key influences on behaviour change to be targeted in interventions.
Late adolescence to early adulthood is the time of life when overweight and obesity rise the fastest, but we know little about the factors that drive changes in obesity-related behaviours, such as diet and physical activity over this period. Adolescence and early adulthood is a time of rapid personal development, incorporating many life events such as changes in living situation, education/occupational status, relationships and parenthood. These life events may incorporate changes in social and physical environments and financial resources, identified as determinants of health behaviour. Our research aims to understand the processes and mechanisms that shape behaviour during this period, to determine how best to intervene in this age group to promote establishment of healthy behaviours which persist in adulthood. More about this theme.
Key observational studies the programme is leading or involved in:
- Following Adolescents into Adulthood (FAIA)
- International Children’s Accelerometry Database (ICAD)
- Southampton Women’s Survey (SWS)
- SPACE: Studying Physical Activity in Children and their Environment study
- SPEEDY: Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people
- Systematic literature reviews of changes in diet, physical activity and adiposity across life events in early adulthood
2. Development and evaluation of interventions to promote physical activity in young people
Intervention development and evaluation are a core part of the programme. This consists of both the evaluation of existing intervention strategies and the synthesis of existing evidence, as well as the development of novel evidence-based interventions. For the latter, we use a structured and iterative approach, and undertake explanatory trials to understand the feasibility and effectiveness of specific intervention strategies based on our previous observations. This approach allows for a greater understanding of the causal mechanisms behind behaviour change, and the potential effectiveness of specific components of future, more complex, interventions to be evaluated later.
Results from our observational studies directly inform the development of intervention studies. For example, in the SPEEDY study we showed the importance of family and home environmental factors for children’s physical activity but intervention evidence is inconclusive. We are therefore testing the feasibility an intervention aimed at promoting family physical activity using self-monitoring, action planning and goal setting strategies targeted at the family (FRESH).
Physical activity promotion is relatively understudied in adolescent populations. Our GoActive and CASE studies focus on promoting physical activity through secondary schools. In both studies, interventions were developed with stakeholders and the target population following an extensive programme of work focussed on observational analyses and evidence synthesis. In CASE, we evaluate the feasibility of introducing active lessons into secondary schools, whereas GoActive is a universal intervention targeting physical activity behaviour change through the school’s social environment. A full evaluation of the GoActive programme is currently underway.
Key intervention projects the programme is leading or involved in:
- Creating Active School Environments (CASE)
- Children’s Health in London and Luton (CHILL)
- Families Reporting Every Step to Health (FRESH)
- Olivia Alliott – PhD Student
- Sofie Armitage – Research Assistant
- Campbell Foubister – Ph.D. Student
- Erin Hoare – Visiting Fellow from Deakin University, Melbourne, Australia
- Kathryn Hesketh – Sir Henry Wellcome Postdoctoral Fellow
- Erika Ikeda – Post-doctoral Fellow
- Sonja Klingberg – PhD Student
- Katie Morton – Career Development Fellow
- Harriet Rowthorn – Research Assistant
- Mairead Ryan – PhD Student
- Esther van Sluijs – Programme Leader
- Andre Werneck – Visiting student from Universidade Estadual Paulista, São Paulo, Brazil.
- Eleanor Winpenny – Research Associate