BACKGROUND Environmental factors influence children's development. However, their impact on outdoor play among children from international settings remains understudied. This study examined associations between parent perceptions of environmental factors and outdoor play among an international sample of preschool-aged children. METHODS Data were sourced from the pilot phases of the SUNRISE International Study of Movement Behaviors in the Early Years. Parents completed a questionnaire about their child's outdoor play and environmental factors that influenced their child's participation in outdoor play in the past 3 days. RESULTS 1855 children from 19 countries (16 low- and middle-income countries) were examined. Heat (-25.6; 95% CI, -44.6 to -6.6), cold (-26.9; 95% CI, -45.9 to -8.4), and rain (-24.8; 95% CI, -43.3 to -6.6) were negatively associated with weekday outdoor play. Cold (-41.2; 95% CI, -62.4 to -20.0) and social instability (-40.7; 95% CI, -61.5 to -20.3) were negatively associated with weekend outdoor play. Playing at friend's or relative's homes (29.5 [95% CI, 18.6 to 40.5]; 37.9 [25.6 to 50.4]), greenspaces (23.1 [95% CI, 9.6 to 36.6]; 30.4 [95% CI, 15.1 to 45.8]), and on the street (41.4 [95% CI, 26.9 to 55.7]; 34.9 [95% CI, 18.2 to 51.3]) were associated with weekday and weekend day outdoor play, respectively. Playing on the family's property was also associated with weekend day outdoor play (25.5 [95% CI, 18.2 to 51.3]). CONCLUSIONS The environmental context is important to consider when developing interventions to promote outdoor play in young children across diverse international settings. Future research from representative populations is needed to confirm these findings.

STUDY OBJECTIVES To examine 1) multidimensional sleep profiles in pre-schoolers (3-6 years) across geocultural regions and 2) differences in sleep characteristics and family practices between Majority World regions (Pacific Islands, Sub-Saharan Africa, Eastern Europe, Northeast Asia, Southeast Asia, South Asia, the Middle East and North Africa, Latin America) and the Minority World (the Western world). METHODS Participants were 3507 pre-schoolers from 37 countries. Nighttime sleep characteristics and nap duration (accelerometer: n=1950) and family practices (parental questionnaire) were measured. Mixed models were used to estimate the marginal means of sleep characteristics by region and examine the differences. RESULTS Geocultural region explained up to 30% of variance in sleep characteristics. A pattern of short nighttime sleep duration, low sleep efficiency, and long nap duration was observed in Eastern Europe, Northeast Asia, and Southeast Asia. The second pattern, with later sleep midpoints and greater night-to-night sleep variability, was observed in South Asia, the Middle East and North Africa, and Latin America. Compared to the Minority World, less optimal sleep characteristics were observed in several Majority World regions, with medium-to-large effect sizes (∣d∣=0.48-2.35). Several Majority World regions reported more frequent parental smartphone use during bedtime routines (Northeast Asia, Southeast Asia: 0.77-0.99 units) and were more likely to have electronic devices in children's bedroom (Eastern Europe, Latin America, South Asia: OR=5.97-16.57) and co-sleeping arrangement (Asia, Latin America: OR=7.05-49.86), compared to the Minority World. CONCLUSIONS Pre-schoolers' sleep profiles and related family practices vary across geocultural regions, which should be considered in sleep health promotion initiatives and policies.

There is little knowledge about within- and between-referee variation (WBRV) in cardiovascular responses (CVR) and locomotor game demands (LMD). Thus, the primary aim of this study was to assess the WBRV of CVR and LMD in male basketball referees during elite international games in preparation [e.g., warm-up (WU) and re-warm-up (R-WU)] and active game phases. The secondary aim was to explore quarter-by-quarter differences in CVR and LMD. Thirty-five international male referees took part in this study (age, 40.4 ± 5.4 years; body height, 184.9 ± 5.7 cm; body weight, 85.1 ± 7.5 kg; BMI, 24.0 ± 1.7 kg × m−2; fat%, 18.8 ± 4.7% and VO2max, 50.4 ± 2.2 L × kg−1 × min−1. In total, 76 games (e.g., 228 officiating cases) were analyzed during the FIBA elite men’s competition. They officiated 4.5 games on average (range 3–9 games). Each referee used the Polar Team Pro system to measure CVR [e.g., heart rate (HR), time spent in different HR intensity categories] and LMD (e.g., distance covered, maximal and average velocity, and number of accelerations). Results showed that the referees had bigger WBRV during the active and preparation (e.g., W-U than R-WU) phase when variables of higher CVR and LMD intensity were observed (e.g., time spent at higher HR zones, distance covered in higher speed zones). The WBRV, CVR, and LMD were higher during WU than R-WU. Moreover, the referees had a lower CVR and LMD in the second half. In conclusion, the referees should establish and follow consistently a game-to-game preparation routine and attempt to spread their on-court preparation time equally within the crew. A half-time preparation routine should be improved to re-establish a sufficient activation level similar to that achieved in pre-game preparation.

The World Health Organization (WHO) released guidelines for physical activity (PA), sedentary behavior, and sleep for children under 5 years of age in 2019, but there are no reports on the adherence to the guidelines in southeastern Europe. This study aimed to: (i) determine the proportion of preschool children (aged 3-5 years) who met the WHO guidelines and examine the feasibility of the proposed protocol for the SUNRISE study in Bosnia and Herzegovina (B&H), and (ii) define sex-, and urban/rural-living-specifics in movement-behaviors, anthropometrics, gross-motor-skills, fine-motor- skills, and cognitive-skills. The sample comprised 115 preschool children (63 girls and 52 boys), residing in urban (n = 66) and rural areas (n = 49) from B&H. Participants were tested on movement behaviors (PA, sleep time, screen time) by accelerometry and comprehensive questionnaires. Body height, weight, body mass index, executive function, fine-, and gross-motor skill, and cognitive function were also measured. The results showed that PA-, sleep duration-, and screen time guidelines were met by 64%, 74% and 53% of children, respectively, while only 23% of the children met all three guidelines on movement behaviors. Boys exhibited higher PA than girls, but no differences in gross- and fine motor skills and cognitive functioning were recorded between the sexes. Children living in urban and rural environments did not differ in any of the studied variables. Results evidenced preschool children from B&H being in line with other samples globally about study variables. Although PA was higher in boys than in girls it was not translated to differences in motor skills. Further studies on larger samples and other environments are warranted.

Physical literacy (PL) is considered an important determinant of physical activity level (PAL), but studies have rarely examined the associations between PL and PAL in preadolescents. This study aimed to evaluate associatios between PL, PAL and sedentary behavior (SB) in preadolescents from southeastern Europe. The participants were 9- to 11-year-old children from Croatia and Bosnia and Herzegovina (n=333, 52% girls) who were tested for PL, PAL and SB. The PLAYself questionnaire was used for the evaluation of PL, while PAL was estimated by data provided throughout the Physical Activity Questionnaire for Children (PAQ-C). Pearson’s correlations and multiple regressions were calculated to identify the associations between study variables. The results revealed a significant correlation between PL and PAL in the total sample (16% of the common variance) among boys (10% of the common variance) and girls (25% of the common variance), which was additionally confirmed by multiple regression calculated between the PL subdomains and PAL (R2=0.23, 0.15, and 0.31 for total sample, boys and girls, respectively). The SB was not significantly correlated with PL (<2% of the common variance; p>0.05) or with PAL (<1% of the common variance; p>0.05). The results indicated a stronger association between PL and PAL in girls than in boys, indicating the possible influence of the types of physically demanding activities children are involved in on the studied associations. To explore causality more specifically, intervention studies are warranted.

The COVID-19 pandemic negatively influenced individuals’ physical activity levels (PALs) and particularly the PAL of the elderly. However, few studies have examined the correlates of PALs in this population during the pandemic. This study aimed to evaluate the residence-specific correlates of PALs in elderly people from Croatia and Bosnia and Herzegovina during the COVID-19 pandemic. The participants were 211 persons older than 65 years (101 females), of whom 111 were community-dwelling residents, and 110 were nursing home residents (71.11 ± 3.11 and 72.22 ± 4.01 years of age, respectively; t-test = 0.91, p < 0.05). The variables included health status, residential status sociodemographic factors, anthropometrics (body mass, height, and body mass index), and PAL. PAL was evaluated using a translated version of the Physical Activity Scale for the Elderly (PASE), and was validated in this study. PASE showed good test–retest reliability (51% of the common variance) and validity (57% of the common variance, with the step count measured using pedometers). Apart from participants’ health status and age, PAL was positively correlated with (i) community-dwelling residence (OR = 1.93, 95% CI: 1.60–2.23), and (ii) a lower BMI (OR = 0.85, 95% CI = 0.71–0.98). The pre-pandemic physical activity was positively correlated with the PAL of the nursing home residents (OR = 1.2, 95% CI: 1.02–1.45). A higher education level was positively correlated with the PAL of community-dwelling residents (OR = 1.31, 95% CI: 1.04–1.66). This study evidenced the residence-specific correlates of PALs, and enabled the identification of specific groups that are at risk of having low PALs during the pandemic. Future studies examining this problem during a non-pandemic period are warranted.

The awareness of the importance of physical literacy (PL) is globally increasing; however, knowledge of the applicability of PL measurement tools in southeastern Europe is limited. The aim of this study was to evaluate the reliability and validity of translated versions of the CAPL-2 and PLAYself questionnaires in 9- to 11-year-old elementary school children from Croatia, Bosnia and Herzegovina, and Montenegro. The participants were 303 children (141 girls; all 9 to 11 years of age) from Croatia (n = 71), Bosnia and Herzegovina (n = 162), and Montenegro (n = 70), enrolled in regular elementary school. The participants were tested throughout a test–retest procedure using two PL evaluation tools, i.e., the Canadian Assessment of Physical Literacy (shorter version, CAPL-2) and the Physical Literacy Assessment of Youth (PLAYself) questionnaires. With an intraclass correlation (ICC) of 0.70–0.80 for specific questionnaire subscales and 0.84 for the total score, PLAYself was found to be reliable. With Kappa values of 0.11–0.23 and a percentage of absolute agreement of less than 62%, CAPL-2 appeared to be less reliable. Factors related to sport participation were significantly positively associated with the PLAYself score, indicating its proper validity. In conclusion, we suggest the usage of the PLAYself questionnaire in further studies examining PL in children of a similar age in the region. Future studies in other age groups and languages are also warranted.

Abstract Introduction. COVID-19 pandemic increased consumption of alcohol (including harmful drinking – HD), and decreased physical activity levels (PAL) globally, but there is an evident lack of studies examining the problem in the post-pandemic period. This study aimed to evaluate gender-specific associations between sport participation and PAL (independent variables), and HD (dependent variable) among college/university students during the first post-pandemic year of the COVID-19 pandemic. Material and Methods. The participants were college/university students, aged 18 to 21 years (n = 788; 409 females) from Croatia and Bosnia and Herzegovina. They were tested on socio-demographic factors, HD (using the AUDIT scale), sport participation and PAL (using the IPAQ questionnaire). Analysis of variance, Chi square test, and t-test for independent samples were used to evaluate differences, while logistic regression with dichotomized criterion (HD vs. non-harmful drinking – NHD) was calculated to establish associations between independent and dependent variables. Results. T-test indicated significant differences between HD and NHD in PAL (t-test = 2.16, p = 0.02), but only in males. Also, logistic regression indicated a significant correlation between PAL and HD in males (OR: 1.41, 95%CI: 1.11-1.76), while no association was evidenced: (i) between sport participation and HD (in both males and females), and (ii) between PAL and HD (in females). Conclusions. Results indicated that an overall increase in PAL could be helpful in decreasing HD among college/university students; however, to evaluate it more specifically, prospective analyses are needed.