Background: Healthy development of children is under pressure. While governments, schools and organizations are trying to stimulate physical activity in children, reduce overweight and improve motor skills, they are facing challenges in finding effective strategies. The model proposed by Stodden et al. (2008) is an interesting framework for studying healthy development of children, as it encompasses the physical aspect (motor skill competence, physical fitness, weight status), the mental aspect (perceived competence) and a behavioral component (physical activity). Importantly, it acknowledges the developmental stages of children by including age. Therefore, this model serves as the basis for this study in which we are looking for insights to effectively influence healthy development of children. Methods and Results: We measured these five variables in a large sample (N > 1000) of children in the Netherlands (age: 4-12, 50% girls). Through structural equation modeling we searched for cross-sectional as well as 1-year longitudinal relationships. Our results showed concurrent relationships between all variables and a tipping point at which relationships emerged or strengthened. The results indicated that targeting motor competence at a young age might be a feasible way to ensure continued participation in physical activities. However, longitudinal analyses revealed no effect of motor skill competence (T1) on physical activity (T2). Physical fitness appeared to be more important as a potential mediator than perceived motor competence. As a follow-up study, the five variables will be analyzed via a person-centered approach (latent profile analyses). This will guide us towards tailoring future interventions to the specific needs of subgroups of children. Analyses of this study are ongoing and will be presented at the conference. Conclusions: Our multiple analyses have shed additional light on the complexity of healthy development of children. In the upcoming presentation we will unite our study findings and delineate implications for developing effective strategies.
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Background: Research in maternity care is often conducted in mixed low and high-risk or solely high-risk populations. This limits generalizability to the low-risk population of pregnant women receiving care from Dutch midwives. To address this limitation, 24 midwifery practices in the Netherlands bring together routinely collected data from medical records of pregnant women and their offspring in the VeCaS database. This database offers possibilities for research of physiological pregnancy and childbirth. This study explores if the pregnant women in VeCaS are a representative sample for the national population of women who receive primary midwife-led care in the Netherlands. Methods: In VeCaS we selected a low risk population in midwife-led care who gave birth in 2015. We compared population characteristics and birth outcomes in this study cohort with a similarly defined national cohort, using Chi Square and two side t-test statistics. Additionally, we describe some birth outcomes and lifestyle factors. Results: Midwifery practices contributing to VeCaS are spread over the Netherlands, although the western region is underrepresented. For population characteristics, the VeCaS cohort is similar to the national cohort in maternal age (mean 30.4 years) and parity (nulliparous women: 47.1% versus 45.9%). Less often, women in the VeCaS cohort have a non-Dutch background (15.7% vs 24.4%), a higher SES (9.9% vs 23.7%) and live in an urbanised surrounding (4.9% vs 24.8%). Birth outcomes were similar to the national cohort, most women gave birth at term (94.9% vs 94.5% between 37 + 0–41+ 6 weeks), started labour spontaneously (74.5% vs 75.5%) and had a spontaneous vaginal birth (77.4% vs 77.6%), 16.9% had a home birth. Furthermore, 61.1% had a normal pre-pregnancy BMI, and 81.0% did not smoke in pregnancy. Conclusions: The VeCaS database contains data of a population that is mostly comparable to the national population in primary midwife-led care in the Netherlands. Therefore, the VeCaS database is suitable for research in a healthy pregnant population and is valuable to improve knowledge of the physiological course of pregnancy and birth. Representativeness of maternal characteristics may be improved by including midwifery practices from the urbanised western region in the Netherlands.
Objective reduction of physical activity (PA) during pregnancy is common but undesirable, as it is associated with negative outcomes, including excessive gestational weight gain. Our objective was to explore changes in five types of activity that occurred during pregnancy and the behavioural determinants of the reported changes in PA. Design we performed a secondary analysis of a cross sectional survey that was constructed using the ASE-Model – an approach to identifying the factors that drive behaviour change that focuses on Attitude, Social influence, and self-Efficacy. Participants 455 healthy pregnant women of all gestational ages, receiving prenatal care from midwifery practices in the Netherlands. Findings more than half of our respondents reported a reduction in their PA during pregnancy. The largest reduction occurred in sports and brief rigorous activities, but other types of PA were reduced as well. Reduction of PA was more likely in women who considered themselves as active before pregnancy, women who experienced pregnancy-related barriers, women who were advised to reduce their PA, and multiparous women. Fewer than 5% increased their PA. Motivation to engage in PA was positively associated with enjoying PA. Key conclusions and implications for practice all pregnant women should be informed about the positive effects of staying active and should be encouraged to engage in, or to continue, moderately intensive activities like walking, biking or swimming. Our findings concerning the predictors of PA reduction can be used to develop an evidence-based intervention aimed at encouraging healthy PA during pregnancy.
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