Environmental and social influences on physical activity

Lead Research Organisation: Medical Research Council
Department Name: Medical Research Council

Abstract

Obesity in both children and adults is becoming increasingly common in this and other developed countries. Although the precise causes remain unclear, evidence suggests that even fairly small changes in physical activity could help to reverse this damaging trend. Physical activity also reduces risks of heart disease, diabetes, osteoporosis and even some cancers. Unfortunately, levels of activity appear to be decreasing in adults and may also be in children, although there is surprisingly little information available to confirm this. Approaches to increase activity, for example exercise prescriptions from the family doctor, have had limited success. There are many reasons put forward as to why people are inactive and what could be done to encourage activity. These cover such diverse areas as government policy concerning transport through to availability of school playing fields, sports facilities and a pleasant neighbourhood. Some are more easily altered than others. Before making potentially unhelpful and expensive recommendations it is useful to know how sedentary adults and children actually are and which factors (psychological, cultural, environmental and so on) are most strongly associated with inactivity. It would then be logical to target some of these factors in an effort to increase activity.

We propose to measure physical activity in adult volunteers by questionnaire and in 9-10 year old school children by questionnaire and also by using a matchbox sized device called an accelerometer worn on the waist which measures movement rather like a pedometer. The questionnaires will also assess a range of volunteer characteristics thought to be associated with activity including perceptions of the environment. In addition we will assess the built environment eg school and neighbourhood using both direct observation and a geographical information system that contains data on factors such as street lighting, garden size and traffic levels. This will enable the measures of physical activity and the assessment of the environment to be linked for each volunteer. We then plan to interview families to identify the barriers and opportunities to promoting physical activity. Finally we will present the results to interested groups with responsibility for health, children and the environment such as school governors, head teachers, Norfolk Children?s Services and also Cambridge Horizons, Local Authorities and the East of England Development Agency who are responsible for delivering nearly 50,000 new homes and #2.2billion of support infrastructure in the wider vicinity of Cambridge by 2016.

Technical Summary

Sedentary living is a major public health problem as it accounts for more than 11 % of all deaths in developed countries and is causally associated with coronary heart disease, diabetes, osteoporosis and some cancers. Interventions aimed at increasing population levels of physical activity have had only modest success and in order to develop effective interventions to halt or reverse the population decline in physical activity, a better understanding of the potentially modifiable determinants of physical activity is required. These physiological, psychological, socio-cultural and environmental determinants operate both at the individual and collective or societal level. In children and adults, numerous studies have focussed on studying individual determinants of health behaviour, whereas the collective determinants have previously received little attention. An unsupportive environment may play a part in the reduction in population levels of physical activity and in the rapid rise of obesity levels. However, there is little published UK data, either in children or adults, on the association between subjectively or objectively assessed environmental determinants and physical activity.

The aims of this study, therefore, are to identify objective and subjective environmental determinants of physical activity in middle-aged adults and to describe the patterns and individual and collective determinants of physical activity in children. In the childhood group, we also aim to describe the perceptions of parents concerning their children?s levels of physical activity and to identify opportunities and barriers to increasing levels of activity. Finally we aim to develop measures of the environmental determinants of activity that can be used in subsequent evaluations of natural experiments of environmental change which may impact on physical activity levels.

The proposed study has four phases; observational studies of the individual and environmental determinants of activity in an existing study of adults (Phase 1) and in a new study of children (phase 2) in an area with detailed previously collated environmental Geographical Information System (GIS) data. Phase 3 is a qualitative study nested within the survey of children to assess parental perceptions of environmental barriers and opportunities for activity. Phase 4 is a formal dissemination to key stakeholders, to inform and influence those involved with the design and maintenance of the built environment, and also the development of new measures to evaluate natural experiments.

Publications

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Atkin AJ (2013) Bedroom media, sedentary time and screen-time in children: a longitudinal analysis. in The international journal of behavioral nutrition and physical activity

 
Description DH Childhood obesity social marketing group
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description NICE Evidence Update
Geographic Reach National 
Policy Influence Type Membership of a guidance committee
 
Description NICE programme development group (children and physical activity)
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
 
Description Transport and Health JSNA 2015
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Citation in other policy documents
URL http://www.cambridgeshireinsight.org.uk/JSNA/Transport-and-Health-2014/15
 
Description What works in schools and colleges to increase physical activity?
Geographic Reach National 
Policy Influence Type Citation in other policy documents
URL https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/469703/What_works_in_schoo...
 
Description ESRC/MRC interdisciplinary studentship
Amount £65,000 (GBP)
Organisation Economic and Social Research Council 
Sector Public
Country United Kingdom
Start 10/2008 
End 09/2011
 
Description NIHR Public Health Research Programme
Amount £1,025,361 (GBP)
Funding ID PHR-13/90/18 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 09/2015 
End 02/2019
 
Description NPRI (BanglaDip)
Amount £384,464 (GBP)
Funding ID G0501284 
Organisation Medical Research Council (MRC) 
Department National Prevention Research Initiative (NPRI)
Sector Charity/Non Profit
Country United Kingdom
Start 01/2006 
End 12/2009
 
Description Policy Research Programme (Behaviour and Health Research Unit)
Amount £47,000 (GBP)
Funding ID PR-UN-0409-10109 
Organisation Department of Health (DH) 
Sector Public
Country United Kingdom
Start 01/2011 
End 12/2015
 
Title SPEEDY 
Description SPEEDY (Sport, Physical activity and Eating behaviour: Environmental Determinants in Young people) is a longitudinal cohort study of 2000 9-10 year old children living in Norfolk, UK, who have been well-characterised in terms of physical activity, dietary behaviour, health outcomes and potential individual, socio-cultural and environmental influences on behaviour. Data is available to the wider research community upon submission of an analysis proposal. 
Type Of Material Database/Collection of data 
Year Produced 2008 
Provided To Others? Yes  
Impact To be determined 
URL http://www.mrc-epid.cam.ac.uk/research/studies/speedy
 
Description MRC Social and Public Health Sciences Unit 
Organisation Medical Research Council (MRC)
Department MRC Social & Public Health Sciences Unit
Country United Kingdom 
Sector Public 
PI Contribution Collaborated on development and conduct of several projects and literature reviews.
Collaborator Contribution Collaborated on development and conduct of several projects and literature reviews.
Impact Publications: 18513430, 18505545, 18752663.
 
Description PChillon - SPEEDY 
Organisation University of Granada
Country Spain 
Sector Academic/University 
PI Contribution Hosting for 3 months, providing data from the SPEEDY Project, collaborating on analyses.
Collaborator Contribution Dr Chilon visited us from the University of Granada in Spain, where she is an assistant professor in the Department of Physical Education and Sport. During her visit, Palma engaged with many members of the team and commenced several collaborative analyses. Currently, one paper is in submission with a further 2 in progress.
Impact 25528343
Start Year 2013
 
Description SPEEDY Qualitative Study 
Organisation Medical Research Council (MRC)
Department MRC Social & Public Health Sciences Unit
Country United Kingdom 
Sector Public 
PI Contribution Leading the development of study protocols, data analyses and publications.
Collaborator Contribution Involved in the development of study protocols, data analyses and publications.
Impact Publications in progress
Start Year 2009
 
Description SPEEDY Qualitative Study 
Organisation University of Cambridge
Department Cambridge Institute of Public Health
Country United Kingdom 
Sector Academic/University 
PI Contribution Leading the development of study protocols, data analyses and publications.
Collaborator Contribution Involved in the development of study protocols, data analyses and publications.
Impact Publications in progress
Start Year 2009
 
Description SPEEDY Qualitative Study 
Organisation University of East Anglia
Country United Kingdom 
Sector Academic/University 
PI Contribution Leading the development of study protocols, data analyses and publications.
Collaborator Contribution Involved in the development of study protocols, data analyses and publications.
Impact Publications in progress
Start Year 2009
 
Description UEA 
Organisation University of East Anglia
Department School of Environmental Sciences UEA
Country United Kingdom 
Sector Academic/University 
PI Contribution We have led the development, prosecution and reporting of studies.
Collaborator Contribution Developed protocols, co-wrote grant applications and papers.
Impact Publications: 19014571, 19465403, 18573196, 19906555, 19776141, 21936970, 21131863, 21481505, 21474361, 21609441, 21467592, 21406273, 21270356, 21143901, 20837590, 20854106, 20435506, 20082745, 20171528, 20117551, 19465403, 22436840. Disciplines: Environmental Science, Nutrition.
 
Description UEA Env 
Organisation University of East Anglia
Department School of Environmental Sciences UEA
Country United Kingdom 
Sector Academic/University 
PI Contribution Led the development of protocol, data collection, data analysis and wiritng of reports and papers.
Collaborator Contribution Collaborated on development of protocol, data collection, data analysis and wiritng of reports and papers.
Impact Publications: 19465403, 19776141, 19767350, 19615073, 19000850, 19014571, 18573196
Start Year 2006
 
Description UEA Med 
Organisation University of East Anglia
Department School of Medicine UEA
Country United Kingdom 
Sector Academic/University 
PI Contribution Led the development of protocol, data collection, data analysis and writing of reports and papers.
Collaborator Contribution Collaborated on development of protocol, data collection, data analysis and wiritng of reports and papers.
Impact Publications: 19465403, 19776141, 19767350, 19615073, 19000850, 19014571, 18573196
Start Year 2006
 
Title CASE (Active lessons) 
Description The CASE active lessons intervention is a training programme for secondary school teachers to enable them to incorporate active elements into their lessons. This can take place indoors or outdoors and is to be built into their existing lesson plans. The intervention consists of 2 training sessions for teachers (approx. 2 weeks apart) and ongoing distal support and trouble shooting. The intervention development is nearing completion, with a first feasibility trial planned for spring 2017. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Initial development
Year Development Stage Completed 2017
Development Status Under active development/distribution
Impact None yet 
 
Title FRESH 
Description The Families Reporting Every Step to Health intervention is a self-monitoring and goal-setting intervention targetting the whole family. It is delivered using an online platform on which families virtually travel across the world. Families wear pedometers and are encouraged to set goals to visit new countries/cities. Feasibility testing was conducted in spring/summer 2017, followed by further refinement and PPI testing. A refined version of the intervention will be tested in the FRESH pilot study, commencing Mar 2018. 
Type Preventative Intervention - Behavioural risk modification
Current Stage Of Development Refinement. Non-clinical
Year Development Stage Completed 2017
Development Status Under active development/distribution
Impact None yet 
 
Description Interview with Cambridge News (EvS) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Media (as a channel to the public)
Results and Impact Participated in interview with Cambridge News on physical activity in children.

Quoted in article In a world full of electronic screens and technology, are Cambridge children shunning the outdoors for a virtual reality?
Year(s) Of Engagement Activity 2014
URL http://www.cambridge-news.co.uk/Cambridge/In-a-world-full-of-electronic-screens-and-technology-are-C...
 
Description All Party Committee on Physical Activity 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Joint CEDAR/MRC Epidemiology submission (x2) to All Party Committee on Physical Activity.

Response from The Young Foundation (who are analysing sumbissions, 18.02.14: "we were just highlighting your responses to go to the co-chairs as two of the best responses. Some very useful insights which will be invaluable for us in drawing up our recommendations."
Year(s) Of Engagement Activity 2014
 
Description Big Wednesday event 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? Yes
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Unit took part in Cambridge City Council Chypps "Big Wednesday" event which had an urban festival theme. Stand focused on physical activity and included activities for chlidren to join in. 50-60 children participated in activities at the stand, and about 50 parents talked to volunteers about the Unit and its activities, and the importance of a healthy diet and physical activity.

To be determined.
Year(s) Of Engagement Activity 2014
URL https://www.cambridge.gov.uk/chypps-overview
 
Description CEDAR Evidence Brief "Supporting physical activity in schools" 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact CEDAR Evidence Brief "Supporting physical activity in schools" focus-grouped with public health and sports partnership officials - as well as feedback sought through online survey.

Promoted to CEDAR partners for feedback.
Year(s) Of Engagement Activity 2012
URL http://www.cedar.iph.cam.ac.uk/resources/evidence/eb1-web/
 
Description Cambridge Science Festival 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? Yes
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact Interactive stand at the Cambridge Science Festival. Typical attendance around 300 visitors, including children and adults.

Inquiries from school teachers and members of the public for further information. Excellent feedback from visitors and consistently good attendance at the stand.
Year(s) Of Engagement Activity 2013,2014
URL http://www.cam.ac.uk/science-festival
 
Description Cambridge Science Festival - Guildhall stand (SG & NI) 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Science Festival Stand "It takes a village to build a healthier future" at the 2-day Guildhall hands-on event for families https://www.sciencefestival.cam.ac.uk/events/it-takes-village-build-healthier-future. Stand included information on physical activity quidelines for children and tips on how families can be more active, as well as the Little Snackington and Great Snackington games http://www.mrc-epid.cam.ac.uk/snackington/, and the "Catch your 5-a-day" and hula-hoop challenges.

The stand was visited by about 250 families across the two days. More than 200 copies of the Great Snackington and Little Snackington leaflet were handed out, and 200 copies of the Cambridge MRC Activity book were also taken by visitors to our stand. Saturday was not as busy as Sunday though this allowed stand volunteers to have good conversations with visitors to the stand.
Year(s) Of Engagement Activity 2018
URL https://www.sciencefestival.cam.ac.uk/events/it-takes-village-build-healthier-future
 
Description Change for Life 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Lecture at multidisciplinary meeting for local launch of the national 'Change for Life' health promotion scheme.

N/A
Year(s) Of Engagement Activity 2009
 
Description ESRC website 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Research paper concerning school policies relating to rainfall and physical activity during break times featured on the ESRC website.

No information available.
Year(s) Of Engagement Activity 2011
 
Description East of England Wellbeing Show 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact MRC Epidemiology Stand and talk by Nick Wareham at East of England Well Being Show http://www.eastofenglandwell-beingshow.org.uk/ attended by approximately 1,000 members of the public. Our stand included promotional material for studies that are now recruiting, and an activity to see how exercise affects heart rate.

To be determined.
Year(s) Of Engagement Activity 2014
URL http://www.eastofenglandwell-beingshow.org.uk/
 
Description Evidence Brief - Sitting out physical activity 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Evidence brief entitled 'Sitting out physical activity', describing accumulated evidence on influences on sedentary behaviour in young people.
Year(s) Of Engagement Activity 2015
URL http://www.cedar.iph.cam.ac.uk/resources/evidence/eb-10-children-sedentary-family/
 
Description Evidence Brief: Children's diet and schools 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Evidence Brief: Children's diet and schools. Based on data from SPEEDY study

Distributed amongst CEDAR policy and practitioner network
Year(s) Of Engagement Activity 2012
URL http://www.cedar.iph.cam.ac.uk/resources/evidence/eb-diet-and-schools-web/
 
Description Ghent Lecture (EvS) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact University of Ghent. Gent, Belgium Invited Lecture "Using evidence to inform physical activity promotion" EvS. 25/03/2014



To be determined.
Year(s) Of Engagement Activity 2014
 
Description Invited seminar at Institute of Child Health, UCL (EvS) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Invited seminar at Institute of Child Health, UCL London "Invited seminar Physical activity promotion in young people: where, when and what to target?" Esther van Sluijs

To be determined.
Year(s) Of Engagement Activity 2014
 
Description KC EvS International Society for Behavioural Nutrition and Physical Activity (ISBNPA, Austin, Texas, 2012. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Oral presentations by KC and EvS at the International Society for Behavioural Nutrition and Physical Activity (ISBNPA, Austin, Texas, 2012.

Increased awareness.
Year(s) Of Engagement Activity 2012
 
Description National Child Measurement Programme and nutrition and healthy weight workshop (EvS) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Invited speaker at National Child Measurement Programme and nutrition and healthy weight workshop Cambridge, UK "Workshop Using evidence to inform practice to tackle child obesity"


To be determined.
Year(s) Of Engagement Activity 2013
 
Description Norfolk Council 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Policymakers/politicians
Results and Impact Presented initial study results to managers from Norfolk County Council Children's Services and Healthy Norfolk Schools.

N/A
Year(s) Of Engagement Activity 2008
 
Description Norfolk media 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Interview for radio and newspaper

N/A
Year(s) Of Engagement Activity 2008
 
Description Norfolk schools 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Schools
Results and Impact Distributed newsletters and posters describing the study findings to 93 participating schools.

N/A
Year(s) Of Engagement Activity 2007,2008
 
Description Talk at Fuse workshop (EvS) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Invited keynote speaker. Presentation entitled 'Physical activity promotion in schools - current evidence and remaining challenges' at 3rd Physical Activity Workshop: Physical Activity Interventions in Schools: A Lesson in Good Living (FUSE)

Higher profile in field; collaboration on grant application
Year(s) Of Engagement Activity 2014
URL http://www.fuse.ac.uk/event.php?eid=2563
 
Description The Telegraph comment (EvS) 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Provided expert commentary to Telegraph on a study on parental monitoring of TV viewing and video game use, and its association with BMI in primary school-aged children

Quoted in the Telegraph article"Too much time in front of a screen 'harms children' , Telegraph, in print, Tuesday 18 March 2014, page 17 , Sarah Knapton, Science Correspondent
Year(s) Of Engagement Activity 2014
 
Description UKSBM 2012 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Poster Presentation
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Poster presentation at UK Society for Behaivoural Medicine (UKSBM) 8th Annual Scientific Meeting in Manchester (Dec 2012). Title: Should children's physical activity promotion interventions encourage a wide variety of leisure-time activities?. Authors: HL Brooke, K Corder, SJ Griffin, E van Sluijs

poster presentation
Year(s) Of Engagement Activity 2012
 
Description Workshop on 'Physical activity research' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Workshop on 'Physical activity research', Association of Departments of General Practice, Ireland Annual Scientific Meeting, Queen's University, Belfast.


Not known
Year(s) Of Engagement Activity 2015