cambridge seminar - mrc epidemiology unit
TRANSCRIPT
Movement behaviours and
parenting in the first two years of life
Dr Alessandra Prioreschi
Movement behaviours
South African movement guidelines for the early years
One guidelineTwo guidelinesZero guidelines
Sleep
Physica
l Act
ivity
Seden
tary
/scre
en
Combin
ed
0
25
50
75
100
Per
cent
age Meeting guidelines
Not meeting guidelines
Percentage of infants meeting guidelines (0-2years)Maternal Reported Data
13%
58%
2%
37%
10%
53%
Compliance with guidelinesPhysical Activity
• Meeting PA guideline was associated with higher subcutaneous adipose fat, but not with higher BMI.
• Males met more guidelines than females, and were more likely to meet the physical activity guideline• Infant tummy time ranged from 2-30 min/day (mean of 15 min/day)
• Toddler active time ranged from 120-240 min/day (mean of 151 min/day) Sedentary and Screen time
• Only 2% met the sedentary time guideline, and this was largely driven by screen time.
• Time restrained ranged from 58-210 min/day (mean of 110 min/day) • Screen time ranged from 10-60 min/day (mean of 30 min/day)
Sleep• Meeting the sleep guideline was associated with higher subcutaneous adipose fat, but not with
higher BMI.
• Sleep time was on average 10.21hours/night
Difficulties with assessing physical activity objectively in the first two years
• Sporadic activities• Regular naps• Developmental stages• Subjective measures may miss this • Accelerometer placement and wear
time need to be relevant• Cut points vary• Caregiver influences on data (up to
55% observed)• Feasibility of devices
Aims
• To design a reusable wrist-worn band for the Axivity AX3 device (logging accelerometer) that was suitable for continuous wear by infant/toddlers aged 3-24 months
• To test the feasibility and acceptibility of this device in a Soweto population
Piloting and final design
• Piloting on prototype designs in Cambridge, UK (n=3) and Soweto, South Africa (n=6):• Security of the bands (parents
commented on a range of press stud configuration for fixing bands)
• Inflexibility of a cotton material used in early designs.
• The final designs (full material and component specifications and design patterns) are published under Creative Commons 3.0 BY Attribution licence (see: https://github.com/digitalinteraction/openmovement/wiki).
BA
C D
12am 1a
m2a
m3a
m4a
m5a
m6a
m7a
m8a
m9a
m10
am11
am12
pm1p
m2p
m3p
m4p
m5p
m6p
m7p
m8p
m9p
m10
pm11
pm0
20
40
60
80
Hour of the day
Mea
n V
M
Male
Female
12am 1a
m2a
m3a
m4a
m5a
m6a
m7a
m8a
m9a
m10
am11
am12
pm1p
m2p
m3p
m4p
m5p
m6p
m7p
m8p
m9p
m10
pm11
pm0
20
40
60
80
100
Mea
n V
M
3 months
6 months
12 months
18 months
Hour of the day
12am 1a
m2a
m3a
m4a
m5a
m6a
m7a
m8a
m9a
m10
am11
am12
pm1p
m2p
m3p
m4p
m5p
m6p
m7p
m8p
m9p
m10
pm11
pm0
20
40
60
80
100
Mea
n V
M
Not Mobile
Crawling
Walking
Hour of the day
0-10
10-2020
-3030
-4040
-5050
-6060
-7070
-8080
-90
90-10
0
100-1
10
110-1
20
120-1
30
130-1
40
140-1
50
150-1
60
160-1
70
170-1
80
180-1
90
190-2
00
200-2
10
210-2
20
220-2
30
230-2
40
240-2
50
250-2
60
260-2
70
270-1
80
280-1
90
290-3
00
300-3
10
310-3
20
320-3
30
330-3
40
340-3
50
350-3
60
360-3
70
370-3
80
380-3
90
390-4
000
200
400
600
800
Tim
e (a
vera
ge m
in/d
ay)
160-1
70
170-1
80
180-1
90
190-2
00
200-2
10
210-2
20
220-2
30
230-2
40
240-2
50
250-2
60
260-2
70
270-1
80
280-1
90
290-3
00
300-3
10
310-3
20
320-3
30
330-3
40
340-3
50
350-3
60
360-3
70
370-3
80
380-3
90
390-4
000
2
4
6
8
10
Male
Female
**
LOW INTENSITY
HIGH INTENSITY
HIGH INTENSITY
1am
2am
3am
4am
5am
6am
7am
8am
9am10
am11
am12
pm1p
m2p
m3p
m4p
m5p
m6p
m7p
m8p
m9p
m10
pm11
pm12
am0
20
40
60
80
Mea
n ve
ctor
mag
nitu
de (m
g)
Underweight
Normal
Overweight/Obese
ANOVA p<0.01 b=-1.42, p=0.57
Underweig
ht
Normal
Weig
ht
Overw
eight/O
bese
0
50
100
150
Mea
n ve
ctor
mag
nitu
de (m
g)
Caregiver-Infant interactions
Movement in the first two years of life is likely dependent on opportunities provided by caregivers
• Thereafter, activity is influenced through• Role Modeling• Joint participation• Home environment• GeneticsEvidence in the first two years of life is unclear
• Many confounding variables• Other children• Employment• Time of day
• Mothers physical activity and interaction with infants was shown to influence infant physical activity (0-2 years).
• Infants were more active when they were not with their mother, unless their mother was being active while they were together.
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 2221 21 22 230
20
40
60
80
100
Hour of the day
Mean
vecto
r mag
nitud
e (mg
)Infant PA - mother is caregiver
Infant PA - mother is not caregiver
Mother PA - mother is caregiver
Mother PA - mother is not caregiver
Headcams to measure parent-
infant interactions
Pilot findings for headcam use in SA
POSITIVES
• The majority of mothers reported that they enjoyed using the headcams.
• Instructions given were useful and sufficient
• Other family members did not mind the use of cameras in the home, and in fact enjoyed being involved.
• All mothers reported that they would wear the headcams again, and were interested in viewing the footage obtained; and, in general, were not concerned about breaches in privacy or the use of their data.
NEGATIVES
• The headcams used did not indicate when they were recording, and this made it difficult for some mothers to know whether they switched on correctly.
• Some mothers reported difficulties with using the headband placement of the camera on the infant and suggested different methods of attachment.
• Acceptability, as well as feasibility of the data was better in younger infants due to decreased autonomy of movement and better compliance.
Thank you
• DST-NRF Centre of Excellence in Human Development• Claude Leon Foundation• Newton Fellowship
Contact
[email protected]_Prioreschi