New Insights into Activity Patterns in Children, Found Using Functional Data Analyses

Introduction/Purpose: Continuous monitoring of activity using accelerometers and other wearable devices provides objective, unbiased measurement of physical activity in minute-by-minute or finer resolutions. Accelerometers have already been widely deployed in studies of healthy aging, recovery of function after heart surgery, and other outcomes. Although common analyses of accelerometer data focus on single summary variables, such as the total or average activity count, there is growing interest in the determinants of diurnal profiles of activity. Methods: We use tools from functional data analysis (FDA), an area with an established statistical literature, to treat complete 24-h diurnal profiles as outcomes in a regression model. We illustrate the use of such models by analyzing data collected in New York City from 420 children participating in a Head Start program. Covariates of interest include season, sex, body mass index z-score, presence of an asthma diagnosis, and mother's birthplace. Results: The FDA model finds several meaningful associations between several covariates and diurnal profiles of activity. In some cases, including shifted activity patterns for children of foreign-born mothers and time-specific effects of asthma on activity, these associations exist for covariates that are not associated with average activity count. Conclusion: FDA provides a useful statistical framework for settings in which the effect of covariates on the timing of activity is of interest. The use of similar models in other applications should be considered, and we make code public to facilitate this process.