To examine the associations among preschoolers fundamental motor skills, screen-time, physical activity (PA), and sedentary behavior (SB). Children ages 3-4years were enrolled in a prospective observational trial of PA. Trained assessors conducted the Test of Gross Motor Development-3rdedition (TGMD-3), and the Movement Assessment Battery for Children-2nd edition, and parent-reported child screen-time and sociodemographic information. Children wore an accelerometer for 7days to examine SB and total PA (TPA). TPA was further characterized as moderate-to-vigorous PA (MVPA) or vigorous PA (VPA). Mixed linear models were calculated, controlling for age (for TGMD-3), sex, household income, and accelerometer wear time (for accelerometry models), with childcare center as a random effect. The primary analysis reported on the cross-sectional baseline data of 126 children with complete fundamental motor skill and screen-time data; a subanalysis included 88 children with complete accelerometry data. Children were 3.4 ± 0.5years of age (54% girls; 46% white, 42% African American, 12% other). A total of 48% lived in households at or below the federal poverty level. Children engaged in 5.1 ± 3.6h/day of screen-time. Children's screen-time was inversely related to the Movement Assessment Battery for Children-2nd edition, manual dexterity skills percentile (β (SE) = -1.7 (0.8), p = 0.049). In the accelerometry subsample, children engaged in 5.9 ± 0.9h/day of TPA of which 1.7 ± 0.6h/day was MVPA. Boys engaged in more MVPA and VPA and less SB compared with girls (all p < 0.05). A higher TGMD-3, total score (β (SE) = 0.4 (0.2), p = 0.017) and locomotor score (β (SE) = 0.7 (0.3), p = 0.018) were associated with more VPA but not with TPA or MVPA. Screen-time and television in the bedroom were not related to SB, TPA, MVPA, or VPA. Children's motor skills were positively related to VPA but inversely related to screen-time. Further inquiry into the implications of high exposure to screen-time in young children is needed.

Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the game design and behavior change procedures that best promote G4H effectiveness and to identify and minimize possible adverse effects. Guidelines for ideal use of different types of G4H by children and adolescents should be elucidated to enhance effectiveness and minimize adverse effects. G4H stakeholders include organizational implementers, policy makers, players and their families, researchers, designers, retailers, and publishers. All stakeholders should be involved in G4H development and have a voice in setting goals to capitalize on their insights to enhance effectiveness and use of the game. In the future, multiple targeted G4H should be available to meet a population's diverse health needs in developmentally appropriate ways. Substantial, consistent, and sophisticated research with appropriate levels of funding is needed to realize the benefits of G4H.

Overweight and obese youth, who face increased risk of medical complications including heart disease and type II diabetes, can benefit from sustainable physical activity interventions that result in weight loss.Objective: This study examined whether a 20‐week exergame (i.e., videogame that requires gross motor activity) intervention can produce weight loss and improve psychosocial outcomes for 54 overweight and obese African‐American adolescents.Design and Methods: Participants were recruited from a public high school and randomly assigned to competitive exergame, cooperative exergame, or control conditions. All exergame participants were encouraged to play the Nintendo Wii Active game for 30‐60 min per school day in a lunch‐time or after‐school program. Cooperative exergame participants worked with a peer to expend calories and earn points together, whereas competitive exergame participants competed against a peer. Control participants continued regular daily activities. Outcome measures included changes in weight, peer support, self‐efficacy, and self‐esteem, measured at baseline, and at ∼10 and 20 weeks.Results: Growth curve analysis revealed that cooperative exergame players lost significantly more weight (mean = 1.65 kg; s.d. = 4.52) than the control group, which did not lose weight. The competitive exergame players did not differ significantly from the other conditions. Cooperative exergame players also significantly increased in self‐efficacy compared to the control group, and both exergame conditions significantly increased in peer support more than the control group.Conclusion: Exergames, especially played cooperatively, can be an effective technological tool for weight loss among youth.

Background: The 2016 United States (U.S.) Report Card on Physical Activity for Children and Youth provides a comprehensive evaluation of physical activity levels and factors influencing physical activity among children and youth.Methods: The report card includes 10 indicators: Overall Physical Activity, Sedentary Behavior, Active Transportation, Organized Sport Participation, Active Play, Health-related Fitness, Family and Peers, School, Community and the Built Environment, and Government Strategies and Investments. Nationally representative data were used to evaluate the indicators using a standard grading rubric.Results: Sufficient data were available to assign grades to 7 of the indicators, and these ranged from B- for Community and the Built Environment to F for Active Transportation. Overall Physical Activity received a grade of D- due to the low prevalence of meeting physical activity guidelines. A grade of D was assigned to Health-related Fitness, reflecting the low prevalence of meeting cardiorespiratory fitness standards. Disparities across age, gender, racial/ethnic and socioeconomic groups were observed for several indicators.Conclusions: Continued poor grades suggest that additional work is required to provide opportunities for U.S. children to be physically active. The observed disparities indicate that special attention should be given to girls, minorities, and those from lower socioeconomic groups when implementing intervention strategies.