Physical activity change during adolescence: a systematic review and a pooled analysis

A pragmatic multi-setting lifestyle intervention to improve leisure-time physical activity from adolescence to young adulthood: the vital role of sex and intervention onset time

BACKGROUND

The long-term effectiveness of healthy lifestyle interventions on improving leisure-time physical activity (LTPA) in adolescents and its factors in low- and middle-income communities is unclear. This study is the first to investigate LTPA trends in a population of Iranian adolescents who underwent a multi-setting lifestyle intervention, considering sex and the time of intervention onset.

METHODS

Participants were 2374 adolescents (57.2% girls), aged 12-18 years, who participated in the Tehran Lipid and Glucose Study (TLGS) during 1999-2001 and followed for a median follow-up of 15.9 over five data points every 3 years. Adolescent participants were assigned to the intervention or control groups based on their residential areas. Boys and girls were categorized into 12-15 or 16-18 years old to minimize participants' bio-psychological differences, facilitate environmental interventions by more compliance with the Iranian educational system and identify the best time to start the intervention. All adolescents in the intervention area received healthy lifestyle interventions via the school-, family-, and community-based programs. LTPA was assessed using the reliable and validated Iranian Modifiable Activity Questionnaire (MAQ) version over the five data points. The Generalized Estimating Equations method was used to evaluate educational intervention's effect on LTPA in adolescents during the follow-up.

RESULTS

In boys who experienced the early onset of intervention (12-15 years), the interaction effect of follow-up examinations and the intervention was significant where the impact of the intervention differed over time. In this group, LTPA was higher in the control group than in the intervention group at the first follow-up examination (β = - 1088.54). However, an increasing trend of LTPA was observed in the intervention group until the third follow-up examination (β = 1278.21, p = 0.08, and β = 1962.81, p = 0.02, respectively), with borderline significance levels at the 2nd (P = 0.08) and the 4th (P = 0.08) measurements. The interaction terms and main effects of intervention and follow-up examinations were not significant in boys with late intervention onset. Although older boys in the intervention group had higher LTPA than the control group, there were no significant differences among study groups in all follow-up examinations. Regarding girls, LTPA did not differ significantly between intervention and control groups in all follow-up examinations (P > 0.05).

CONCLUSION

Our results showed that a multi-setting practical lifestyle intervention could improve long-term energy expenditure in LTPA in adolescent boys who have experienced an early onset intervention. Findings emphasized the vital role of gender and the onset of these interventions. The current results would be valuable to plan tailored interventions to improve LTPA and community health.

TRIAL REGISTRATION

This study is registered at Iran Registry for Clinical Trials (IRCT), a WHO primary registry ( http://irct.ir ). The TLGS clinical trial was the very first registration in the IRCT (Iran Registry of Clinical Trials). it was registered on 2008-10-29 by the registration number IRCT138705301058N1 . Based on the international committee of medical journal Editors (ICMJE), "retrospective registration" is acceptable for trials that began before July 1, 2005.

Players at home: Physical activity and quality of life in 12-17 years-old football (soccer) players during the Covid-19 lockdown

BACKGROUND

Aggressive preventive actions were required to face the Covid-19 outbreak. However, from March 2020 on, many healthy youth football players have seen their sporting activities disrupted by the restrictions on outdoor exercise.This study describes physical activity and quality of life during April 2020 lockdown of young people participating in organized football.

METHODS

1163 young football players aged 12-17 years (185 girls) completed a web-based questionnaire including the Youth Physical Activity and the Youth Quality of Life-Short Form Questionnaires; information on lifestyle and football-specific activity were also collected. Differences according to sex, urban/rural context and élite/non-élite club level were tested using a 2 × 2  ×  2 MANOVA (age considered as a covariate).

RESULTS

We found that: (i) on average, exposure to football accounted for 3.2 hours/week, was higher in élite clubs and changed in nature, being mainly performed individually; 19% of participants practiced football <1 hour/week; (ii) only 56% of the participants reported 7 or more hours/week of moderate-to-vigorous physical activity, which decreased with age and changed according to the geographical context; (iii) perceived quality of life was lower in youth playing for non-elite clubs and in older girls; (iv) coaches, rather that official initiatives, were the primary source of football exercises practiced at home.

CONCLUSION

A status of limited physical activity emerged; this might lead to deconditioning and susceptibility to injuries when football could restart. Governing bodies, football Associations and clubs could exploit these results to take informed decisions and support evidence-based interventions during and after the Covid-19 pandemic.

Remote Acculturation and Physical Activity Among Adolescent-Mother Dyads in Jamaica: A Developmental Dyadic Moderation

This study examined the associations between remote acculturation to European American culture of the United States (U.S.), and physical activity levels among Jamaican mother-adolescent dyads. Remote acculturation, a modern type of globalization-facilitated acculturation to a distant non-native culture, is a demonstrated risk factor for some health outcomes, but the association with physical activity has not previously been examined. Mothers and adolescents ( N = 660; 330 dyads) were recruited from schools in Kingston, Jamaica. Actor-Partner Interdependence Moderation Models tested hypotheses about actor and partner effects of U.S. cultural orientation on moderate and vigorous physical activity (MVPA), and the moderation of these effects by developmental stage, socioeconomic status (SES), and gender. We observed a contrast pattern of moderation consistent with increased autonomy granting across adolescence, such that the signs (positive/negative) of the actor and partner effects depended on adolescent developmental stage. The actor effect of adolescents’ U.S. orientation on their own MVPA was negative for early adolescents (unexpected) and positive for mid-adolescents (expected); by contrast, the partner effect of mother’s U.S. orientation on adolescents’ MVPA was positive for early adolescents (expected) and negative for mid-adolescents (unexpected). SES and gender did not moderate the associations. This study contributes to an emerging body of literature on the health correlates of remote acculturation. Our results suggest that whether remote cultural orientation is a risk or protective factor varies based on the health domain in question, developmental stage, the remote culture, and the context.

Physical Activity and Sports Participation among Adolescents: Associations with Sports-Related Knowledge and Attitudes

The impact of physical activity and sport on the development of adolescents' knowledge and attitudes has not been studied sufficiently. We assume that young people with more knowledge of sports will continue to be physically active on their own. The aim of this study is to identify the differences in the sports and physical activity-related knowledge and attitudes of adolescents who engage in organised sports training and those who do not. A total of 1033 6th-grade students from (aged 12.7 ± 0.4 years) 52 schools in Estonia were involved in the study. Logistic regression analysis was used to examine the associations between sports-related knowledge and attitudes towards students participating in organised sports training. The main reasons which hindered adolescents from being active were a lack of suitable equipment, being weaker than others, and laziness. Knowledge of physical activity, higher perceived benefits, and lower barriers to physical activity were the predictors contributing to adolescents' participation in sports training. The results demonstrated that physically active students have better knowledge of sports and physical activity. Students participating in organised sports training have strong positive benefits from being regularly physically active and feel that sports training maintains their health.

The prevalence and correlates of physical activity/inactivity and sedentary behaviour among high-school adolescents in Iran: a cross-sectional study

Background

Physical inactivity and sedentary behaviour are the main risk factors for non-communicable diseases in all stages of life. However, there is a lack of reliable data regarding the recommended level of physical activity and its correlates related to physical inactivity and sedentary behaviour among school students in Iran. The aim of the present study was to report the prevalence and correlates of physical activity/inactivity and sedentary behaviour among Iranian high school adolescents.

Methods

The Global School-based Student Health Survey (GSHS) was used for data collection. Related data comprising socio-demographics, health risk behaviour and protective factors were obtained from 1517 high school students. Multivariate logistic regression was used to assess the association between relevant independent variables (e.g. gender) and the dependent outcome variable (physical inactivity/sedentary behaviour).

Results

The prevalence of recommended physical activity by WHO was 27.8%, physical inactivity 72.2% and sedentary behaviour 71.4%. Being female, being overweight or obese, walking/cycling to or from school on 1–4 days, sitting 3 or more hours/day (sedentary behaviour), insufficient vegetable intake, being bullied and lack of parental support, peer support and parental connectivity (protective factors) were positively associated with physical inactivity. On the other hand, walking/cycling to or from school on 5–7 days and inadequate fruit intake were negatively associated with physical inactivity. Walking/cycling to or from school on 1–4 days, being physically inactive, inadequate fruit intake and being bullied were positively associated with sedentary behaviour.

Conclusion

The prevalence of physical inactivity and sedentary behaviour was high in our studied sample. Interventions that address the issue of active school transport, sedentary behaviour, fruit and vegetable intake, family and peer support and bullying should be given more priority by the public health authorities.

Fitness Changes in Adolescent Girls Following In-School Combined Aerobic and Resistance Exercise: Interaction With Birthweight

PURPOSE

To assess the efficacy of a supervised in-school combined resistance and aerobic training program in adolescent girls and investigate whether responses differ according to birthweight.

METHODS

Participants (girls aged 13-17 y) were randomized either to an intervention replacing physical education (PE) classes with 2 × 60-minute training sessions per week (n = 58) or to a control group that continued to attend 2 × 60 minutes per week of curriculum PE (n = 41). We measured muscular fitness (handgrip, standing long jump, and sit-ups), cardiorespiratory fitness (20-m shuttle run), skinfolds, and lean body mass preintervention and postintervention and determined effect size (Hedge's g) differences between changes in these measures. We also compared changes within lower (<3000 g) and normal birthweight intervention and PE control subgroups.

RESULTS

The intervention group showed greater improvements in all the fitness measures and lean body mass (g = 0.22-0.48) and lower skinfold increases (g = 0.41) than PE controls. Within the intervention group, improvements in all fitness measures were larger in lower birthweight (g = 0.53-0.94) than in normal birthweight girls (g = 0.02-0.39).

CONCLUSION

Replacing curriculum PE with supervised training improved muscular and cardiorespiratory fitness and body composition outcomes in adolescent females. Our findings suggest an enhanced adaptive response to training in participants with lower birthweight which warrants further investigation.

Comparison of Physical Activity Between Children With and Without Autism Spectrum Disorder: A Systematic Review and Meta-Analysis

Lower levels of physical activity (PA) are often observed among children with autism spectrum disorder (ASD) compared to children without ASD; however, some studies have demonstrated few to no PA differences between the two groups. The purpose of this systematic review with meta-analysis was to compare the differences in PA between children (2-18 years) with and without ASD. An exhaustive search of five online databases was completed, and 31 studies met the inclusion criteria. A pooled random-effects Hedges's g model was used to determine differences in PA between children with and without ASD. Children with ASD were found to be significantly less physically active than children without ASD (Δ = -0.62, p < .001). Subgroup analyses revealed significant moderate to large differences in PA by intensity level, age, setting, and measurement methods. Future studies are needed to further explore the underlying mechanisms associated with lower levels of PA among children with ASD.

Barriers to high school and university students' physical activity: A systematic review

Physical inactivity commonly occurs throughout one's life, particularly during adolescence and young adulthood. Multiple factors can negatively influence participation in physical activity, but there has been no review examining the barriers to physical activity among high school and university students. Therefore, the aim of this systematic review was to summarize evidence of barriers to the practice of physical activity among high school and university students. The literature search was conducted without time limits using five databases, including CINAHL, Cochrane Library, Embase, PubMed, and Scopus. In total, 59 studies (37 with high school students [n = 22,908] and 22 with university students [n = 15,411]) were included. The main barriers identified in high school and university students were lack of time, lack of motivation, and lack of accessible places. These findings may be useful in designing and implementing evidence-informed interventions and programs for physical activity promotion in students.

Patterns of age-related change in physical activity during the transition from elementary to high school

This study was designed: 1) to describe patterns of age-related change in total and moderate-to-vigorous physical activity (MVPA) in children as they transitioned from elementary school to high school, and 2) to determine if those patterns differed across demographic sub-groups formed on the basis of gender, race/ethnicity, parent education (socioeconomic status), and urbanicity. A cohort of children (analysis sample, N = 951) was comprised of students drawn from two public school districts in South Carolina. Physical activity was measured by accelerometry on at least two and up to five occasions between 2010 and 2017. Growth curve analyses were performed to describe the pattern of age-related change in the physical activity variables for the full sample and for demographic sub-groups. A relatively steep age-related decline in total physical activity was observed in children before age 14, with a slower rate after that age. Physical activity was lower in girls than boys, and the age-related rate of decline was steeper in girls. Physical activity patterns did not differ across race/ethnicity groups, but children of parents with less education were more active than children of parents with more education. Children living in rural areas participated in less MVPA than children living in urban settings, and this difference increased with increasing age. These findings indicate that children experience a particularly steep decrease in physical activity as they transition from elementary to middle school, and this trend is particularly prominent in girls, children living in rural areas, and children of parents with college education.

Co-design of a school-based physical activity intervention for adolescent females in a disadvantaged community: insights from the Girls Active Project (GAP)

BACKGROUND

Globally, adolescents' physical activity (PA) participation rates are low, particularly among lower socioeconomic groups, with females consistently the least active. The aim of this study was to co-design, with adolescent females, a school-based PA intervention in a single-sex, females-only designated disadvantaged post-primary school in Ireland. This involved using the Behaviour Change Wheel (BCW) and Public and Patient Involvement (PPI). This paper outlines the novel methodological approach taken.

METHODS

The three stages 1) understand the behaviour, 2) identify intervention options, and 3) identify content and implementation options of the BCW guide is described. A student PPI Youth Advisory Group (YAG) (n = 8, aged 15-17) was established. Mixed-methods were used with students (n = 287, aged 12-18) and teachers (n = 7) to capture current self-reported PA levels and to identify factors influencing adolescent females' PA behaviour in their school setting. The intervention options, content and implementation options were identified through discussion groups with the YAG. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention.

RESULTS

Just 1.4% of the students in this sample reported meeting the recommended PA guidelines. Students identified having more 'time' as the strongest predictor to becoming more active in school (Mean = 4.01, 95% CI 3.91 to 4.12). Social influences, environmental context and resources, behavioural regulation, beliefs about capabilities, goals, and reinforcement emerged from the qualitative data as factors influencing PA behaviour at school. The BCW co-design process resulted in the identification of seven intervention functions, four policy categories and 21 Behaviour Change Techniques. The Girls Active Project (GAP) intervention, a peer-led, after-school PA programme was proposed.

CONCLUSIONS

This paper describes how the BCW, a comprehensive, evidence-based, theory-driven framework was used in combination with PPI to co-design a school-based intervention aimed to increase adolescent females' PA levels. This approach could be replicated in other settings to develop targeted behavioural interventions in populations with specific demographic characteristics.

Physical activity and depressive symptoms among adolescents in a school-based sample

Objective:

To explore associations between self-reported weekly physical activity and depressive symptomatology among adolescents in a school-based sample from Brazil.

Methods:

We surveyed 7,405 adolescents aged 14 to 16 years in 101 public schools in Porto Alegre, Brazil. We assessed physical activity using an adapted version of the Patient-Centered Assessment and Counseling for Exercise Plus Nutrition – Adolescent Physical Activity Measure (PACE+), and depressive symptoms using the Brazilian Portuguese version of the Patient Health Questionnaire – Adolescent Version. We compared the depressive symptom scores among adolescents with varying levels of physical activity.

Results:

Of the overall sample, 84.4% exercised less than the recommended frequency of 60 minutes/day, at least 5 days/week, of moderate to intense physical activity (PACE+ score ≥ 5). Adolescents whose physical activity levels fell below that threshold had higher median depression scores (8 [IQR = 10] vs. 7 [IQR = 9], W = 4060461, p < 0.001). A similar pattern was observed for depression scores in those with PACE+ < 1 (median of 10 [IQR = 11]) and ≥ 1 (7 [IQR = 9], W = 7457608, p < 0.001).

Conclusion:

In this large sample of Brazilian adolescents, those who exercised less frequently and vigorously than their peers reported more depressive symptoms.

Changes of Self-Rated Health Status, Overweight and Physical Activity During Childhood and Adolescence-The Ratchet Effect of High Parental Socioeconomic Status

Childhood and adolescence are important life periods for the development of health status and physical activity (PA) behaviours. This study analyses the stability and potential changes of self-rated health status, overweight and PA behaviour over time, specifically focusing on the age and the socioeconomic status of children and adolescents. We employ representative longitudinal data for German children and adolescents from the Motorik-Modul Study and the German Health Interview and Examination Survey. Using four different dichotomous health status and PA indicators (self-rated health status [SRHS]; overweight; moderate-to-vigorous PA; and leisure sports engagement), we report within-person transition rates across the panel waves when the survey was taken (2003-2006, 2009-2012, and 2014-2017). Additionally, we report results of logistic regressions estimating the impact of children's age, gender, migration background, and their parents' socioeconomic status on these transition rates. The transition rates show mixed results. While children and adolescents from highly problematic states reporting bad SRHS and no leisure sports engagement at an early stage tend to improve later on, overweight children mostly stay overweight. Age and social inequality indicators correlate with some of the chances of improving or worsening the health and PA states. Most clearly, high parental status prevents the health status and PA from worsening over all transitions, particularly becoming overweight, representing a ratchet effect. The results of the present study underline that health policy needs to target specific groups to reduce social inequality in the health status and PA of children and adolescents.

Do adolescents' experiences of the barriers to and facilitators of physical activity differ by socioeconomic position? A systematic review of qualitative evidence

This review aims to systematically identify and synthesize qualitative data on adolescents' experiences of the barriers to and facilitators of physical activity to understand whether these differ by socioeconomic position. Multiple databases (MEDLINE, Web of Science Core Collection, PsycINFO, and ERIC) were searched in August 2020. Duplicate title/abstract and full text screening was conducted. Studies were included if they reported qualitative data collected from adolescents (aged 10-19), a measure of socioeconomic position and focused on physical activity. Studies not published in English or published before 2000 were excluded. Relevant data were extracted and methodological quality assessed (in duplicate). Data were analyzed using Thomas and Harden's methods for the thematic synthesis. Four analytical themes emerged from the 25 included studies: (1) social support, (2) accessibility and the environment, (3) other behaviors and health, and (4) gendered experiences. These themes appeared across socioeconomic groups; however, their narratives varied significantly. For example, provision and access to local facilities was discussed as a facilitator to middle and high socioeconomic adolescents, but was a barrier to low socioeconomic adolescents. These findings can be used to inform how different socioeconomic groups may benefit from, or be disadvantaged by, current interventions.

Peer-led physical activity intervention for girls aged 13 to 14 years: PLAN-A cluster RCT

Background

Increasing physical activity among girls is a public health priority. Peers play a central role in influencing adolescent behaviour. Peer-led interventions may increase physical activity in adolescent girls, and a feasibility trial had shown that PLAN-A (Peer-led physical Activity iNtervention for Adolescent girls) had evidence of promise to increase physical activity in adolescent girls.

Objective

The objective was to test whether or not PLAN-A can increase adolescent girls’ physical activity, relative to usual practice, and be cost-effective.

Design

This was a two-arm, cluster-randomised controlled trial, including an economic evaluation and a process evaluation.

Participants

State-funded secondary schools in the UK with girls in Year 9 (aged 13–14 years) participated in the trial. All Year 9 girls in participating schools were eligible.

Randomisation

Schools were the unit of allocation. They were randomised by an independent statistician, who was blinded to school identities, to the control or intervention arm, stratified by region and the England Index of Multiple Deprivation score.

Intervention

The intervention comprised peer nomination (i.e. identification of influential girls), train the trainers (i.e. training the instructors who delivered the intervention), peer supporter training (i.e. training the peer-nominated girls in techniques and strategies underpinned by motivational theory to support peer physical activity increases) and a 10-week diffusion period.

Outcomes

The primary outcome was accelerometer-assessed mean weekday minutes of moderate to vigorous physical activity among Year 9 girls. The follow-up measures were conducted 5–6 months after the 10-week intervention, when the girls were in Year 10 (which was also 12 months after the baseline measures). Analysis used a multivariable, mixed-effects, linear regression model on an intention-to-treat basis. Secondary outcomes included weekend moderate to vigorous physical activity, and weekday and weekend sedentary time. Intervention delivery costs were calculated for the economic evaluation.

Results

A total of 33 schools were approached; 20 schools and 1558 pupils consented. Pupils in the intervention arm had higher Index of Multiple Deprivation scores than pupils in the control arm. The numbers randomised were as follows: 10 schools (n = 758 pupils) were randomised to the intervention arm and 10 schools (n = 800 pupils) were randomised to the control arm. For analysis, a total of 1219 pupils provided valid weekday accelerometer data at both time points (intervention, n = 602; control, n = 617). The mean weekday moderate to vigorous physical activity was similar between groups at follow-up. The central estimate of time spent engaging in moderate to vigorous physical activity was 2.84 minutes lower in the intervention arm than in the control arm, after adjustment for baseline mean weekday moderate to vigorous physical activity, the number of valid days of data and the stratification variables; however, this difference was not statistically significant (95% confidence interval –5.94 to 0.25; p = 0.071). There were no between-arm differences in the secondary outcomes. The intervention costs ranged from £20.85 to £48.86 per pupil, with an average cost of £31.16.

Harms

None.

Limitations

The trial was limited to south-west England.

Conclusions

There was no evidence that PLAN-A increased physical activity in Year 9 girls compared with usual practice and, consequently, it was not cost-effective.

Future work

Future work should evaluate the utility of whole-school approaches to promote physical activity in schools.

Trial registration

This trial is registered as ISRCTN14539759.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 10, No. 6. See the NIHR Journals Library website for further project information. This trial was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a United Kingdom Clinical Research Commission (UKCRC)-registered Clinical Trials Unit that, as part of the Bristol Trials Centre, is in receipt of NIHR Clinical Trials Unit support funding. The sponsor of this trial was University of Bristol, Research and Enterprise Development www.bristol.ac.uk/red/. The costs of delivering the intervention were funded by Sport England.

Investigating the influence of physical activity composition on arterial stiffness in youth

Physical activity is beneficial for arterial health in children but less is known about how all daily movement behaviours influence arterial stiffening. Compositional analysis can account for the co-dependent nature of these behaviours and therefore was employed to explore how the movement composition influences arterial health. Augmentation index (AIx) and pulse wave velocity were measured cross-sectionally in healthy children (n = 129; 12.4 ± 1.6 years). Time spent in sedentary, light physical activity (LPA), moderate-to-vigorous physical activity (MVPA) and asleep were derived from seven-day hip-worn accelerometry. The relative effects of individual behaviours and the overall movement composition on arterial stiffness were explored utilising compositional analysis, with predictive modelling used to predict effects of the substituting time between behaviours. Girls (n = 45, 12.1 ± 1.5yrs, 20.5 ± 3.6kg·m^-2) had a higher AIx (+ 3.94; p < 0.05) and accrued physical activity predominantly in LPA, whereas boys (n = 56, 12.6 ± 1.7yrs, 20.6 ± 4.0kg·m^-2) accrued physical activity predominantly in MVPA. Individual behaviours and the movement composition were not significant predictors of any measure of arterial stiffness (P > 0.05), and the reallocation of 20-minutes between behaviours did not elicit significant change in arterial stiffness, irrespective of sex (P > 0.05). The reallocation of time to MVPA from any other behaviour did not predict an improvement in arterial stiffness. This highlights the high potential dose of MVPA required to improve arterial health and the complex nature of the determinants of arterial stiffness. HighlightsMovement behaviours in isolation nor combination predicted arterial stiffness in youth.The reallocation of behaviours from any other behaviour to MVPA did not affect arterial stiffness in youth.Arterial stiffness is a complex, multidimensional health parameter that does not appear to be primarily determined by physical activity levels or intensity.

Adolescents' Physical Activity and Depressive Symptoms: A Psychosocial Mechanism

Guided by the Theory of Planned Behavior (TPB; Ajzen, 1991), this study aimed to test a hypothesized path model of TPB variables (i.e., attitude toward behavior, subjective norm, perceived behavioral control, and intention) with physical activity (PA) and depressive symptoms. A total of 792 Chinese adolescents (M_age = 16.9; SD = 0.82; 54.5% females) completed previously validated questionnaires assessing their TPB variables, PA, and depressive symptoms. Correlation analysis revealed TPB variables were positively associated with PA (p < 0.01), and negatively correlated to depressive symptoms (p < 0.01). The path analyses indicated that the hypothesized model produces a goodness of fit (χ²/df = 16.14/5, CFI = 0.99, RMSEA = 0.06). The findings support the theoretical tenets of TPB and provide empirical evidence of the psychosocial mechanism of PA and depressive symptoms in Chinese adolescents. It suggests that building PA intervention strategies while considering the TPB framework may promote adolescents' physical and mental health.

Predicting Dropout From Organized Football: A Prospective 4-Year Study Among Adolescent and Young Adult Football Players

Previous studies have shown that enjoyment is one of the key predictors of dropout from organized sport, including organized football. However, prospective studies, particularly studies focused on long-term dropout, are largely lacking. Drawing on the basic principles of interdependence theory, in the present prospective study among 1,762 adolescent and young adult football players (27.1% women, mean age 17.74 years, SD = 1.35), we tested the predictive value of sport enjoyment, perceived alternatives, and restraining forces on football players' short-term (6 months) and long-term (4 years) dropout from organized football. As anticipated, the results of the logistic regression and follow-up analyses indicate that players' enjoyment was the main predictor of (short-term and long-term) dropout. In addition, relative to remainers, dropouts perceived more alternatives in terms of other sports, had fewer family members involved in their football club, and were older at the time they started playing organized football. We conclude that particularly measures aimed at enhancing sport enjoyment may prevent players from dropping out from organized football in both the short and long term. In addition, dropout rates may be reduced by attracting and engaging youth at a very young age (from 6 years), and their siblings, parents, and other family members as well.

Prevalence and trends in Australian adolescents' adherence to 24-hour movement guidelines: findings from a repeated national cross-sectional survey

BACKGROUND

24-hour movement guidelines recommend a healthy balance of high levels of physical activity, low levels of sedentary behaviour and appropriate sleep duration each day. At present, surveillance data on how Australian adolescents are performing against these guidelines are lacking. This study aims to describe the extent to which Australian secondary school students are adhering to the physical activity, sedentary recreational screen time and sleep duration recommendations outlined in the national 24-hour movement guidelines for children and young people. It also examines whether there are socio-demographic differences in levels of compliance and if there have been significant changes in these behaviours over time.

METHODS

A repeated national cross-sectional survey of students in grades 8 to 11 (ages 12-17 years) was conducted in 2009-2010 (n=13,790), 2012-2013 (n=10,309) and 2018 (n=9,102). Students' self-reported physical activity, screen time and sleep behaviours were assessed using validated instruments administered in schools via a web-based questionnaire.

RESULTS

In 2018, around one in four students (26%) did not meet any of the 24-hour movement guidelines, while only 2% of students met all three. Adherence to the sleep duration recommendation was highest (67%), with substantially smaller proportions of students meeting the physical activity (16%) and screen time (10%) recommendations. Differences in adherence by sex, grade level and socio-economic area were apparent. Students' compliance with the screen time recommendation has declined over time, from 19% in 2009-2010 to 10% in 2018. However, there has been no significant change in the proportion meeting the physical activity (15% in 2009-2010 cf. 16% in 2018) and sleep duration (69% in 2009-2010 cf. 67% in 2018) recommendations. Compliance with all three guidelines has remained very low (<3%) across each survey round.

CONCLUSIONS

There is considerable scope to improve Australian adolescents' physical activity and sedentary behaviours in line with the national 24-hour movement guidelines. Policy proposals and environmental interventions, particularly those focused on replacing sedentary screen time with physical activity (e.g. promotion of active commuting to/from school), are needed to better support Australian adolescents in meeting the 24-hour movement guidelines.

Characterizing Middle School Students' Physical Literacy Development: A Self-Determination Theory-Based Pilot Intervention in Physical Education

Purpose: Positive youth development (PYD) can be achieved through effective and purposeful instructions in physical education (PE) and other relevant experiences both in and beyond schools. Students' PYD is associated with their physical literacy (PL) development, which has become a primary emphasis of PE, especially in the United States, in recent years. This study aimed to (a) characterize middle school students' physical literacy (PL) and (b) capture their PL developing trajectories in light of receiving a self-determination theory (SDT)-based pedagogical workshop, with the long-term vision on PYD.

Methods: Participants (N = 226) completed the Canadian Assessment of Physical Literacy (CAPL-2) in physical education (PE). A subsample (n = 49) received four workshop sessions over 8 weeks; and completed the CAPL-2 and participated in focus group interviews before and after the workshop.

Results: Both boys and girls' CAPL-2 scores were in the “progressing” stage. Significant differences in PL and PL domains were observed by gender, grade, socioeconomic status (SES), body mass index (BMI), and race/ethnicity. The low PL group showed improvements in PL and PL domains. Interview data delineated positive PL developing trajectories for physical activity (PA) type, frequency, and intensity; perceived motives; and participation barriers.

Conclusion: PL is a dynamic state that can be improved through purposeful PE. Future work should examine the effect (and implementation) of opportunities in (e.g., PE) and beyond schools (e.g., youth sports programs) to ultimately advance PYD.

Physical Activity in High School Classrooms: A Promising Avenue for Future Research

Adolescence represents a sensitive period whereby lifestyle factors such as physical activity can have profound, long-lasting effects on development and later life habits. However, adolescence constitutes a period of frequent sedentary behaviour. Among children, integrating physical activity into elementary school classrooms has been shown to reduce sedentary behaviour and improve academic achievement and overall physical and mental health. However, this promising area of research has not extended to adolescents and high school classrooms. In this paper, we describe the benefits of conducting research on the impact of physically active high school classrooms, and highlight the challenges and potential misconceptions associated with research in this field. Specifically, we review research on the role of physical activity in adolescent development, the benefits of classroom-based physical activity for children, and discuss the factors that may have led researchers to focus on classroom-based physical activity primarily for children, despite the potentially similar benefits for adolescents.

Sufficient sleep duration in autistic children and the role of physical activity

LAY ABSTRACT

Higher levels of physical activity may be associated with improved sleep in children, but this relationship is still being determined, especially in autistic children. In this study, we used existing data from the 2018 National Survey of Children's Health. Caregivers of children 6-17 years old, including caregivers of autistic children, completed a questionnaire that included questions about physical activity (days active in the past week) and sleep duration. We then determined if children were obtaining the recommended hours of sleep for their age (i.e. sufficient sleep). We found that higher physical activity levels were associated with sufficient sleep duration, but this finding was weaker in autistic children. In particular, this association was not observed in autistic children with more severe autism spectrum disorder, female autistic children, and autistic children 6-12 years old. In conclusion, physical activity is a promising approach to help children obtain sufficient sleep duration. However, more personalized approaches to improving sleep may be needed for certain groups of autistic children.

Clinical responses following inspiratory muscle training in exercise-induced laryngeal obstruction

Purpose

Exercise-induced laryngeal obstruction (EILO) is relatively common in young people. Treatment rests on poor evidence; however, inspiratory muscle training (IMT) has been proposed a promising strategy. We aimed to assess laryngeal outcomes shortly after IMT, and to compare self-reported symptoms with a control group 4–6 years later.

Methods

Two groups were retrospectively identified from the EILO-register at Haukeland University Hospital, Norway; one group had received only information and breathing advice (IBA), and another additionally IMT (IBA + IMT). At diagnosis, all participants performed continuous laryngoscopy during exercise (CLE), with findings split by glottic and supraglottic scores, and completed a questionnaire mapping exercise-related symptoms. After 2–4 weeks, the IBA + IMT-group was re-evaluated with CLE-test. After 4–6 years, both groups were re-assessed with a questionnaire.

Results

We identified 116 eligible patients from the EILO-register. Response rates after 4–6 years were 23/58 (40%) and 32/58 (55%) in the IBA and IBA + IMT-group, respectively. At diagnosis, both groups rated symptoms similarly, but laryngeal scores were higher in the IBA + IMT-group (P = 0.003). After 2–4 weeks, 23/32 in the IBA + IMT-group reported symptom improvements, associated with a decrease of mainly glottic scores (1.7–0.3; P < 0.001), contrasting unchanged scores in the 9/32 without symptom improvements. After 4–6 years, exercise-related symptoms and activity levels had decreased to similar levels in both groups, with no added benefit from IMT; however, full symptom resolution was reported by only 8/55 participants.

Conclusion

Self-reported EILO symptoms had improved after 4–6 years, irrespective of initial treatment. Full symptom resolution was rare, suggesting individual follow-up should be offered.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00405-021-07214-5.

Weight control practices among the Saudi Arabian population during the Covid-19 lockdown

Objectives:

Physical activity appears to be essential to maintain health during the COVID-19 pandemic, specifically for those at high risk, because of its advantages mentally as well as physically. This study determines weight control behaviors among the Saudi population during the COVID-19 pandemic.

Methods:

The study was a cross-sectional survey of Saudis aged 18–60 and residents in the country during the lockdown period. The study sample was 384 people obtained from the Leslie formula for sample size calculations. The population covered all Saudi regions.

Results:

A total of 397 people responded to the survey. Among these people, 196 (49.4%) were male and 201 (50.6%) were female. The majority of them were urban residents (288; 72.5%). One hundred seventy-five (44.1%) had engaged in healthy behavior for weight control during the COVID-19. Factors that significantly affected these healthy behaviors were gender, employment, and educational level (P value <0.05). During pandemic, certain activities and behaviors were affected (P value < 0.05), including smoking (36; 9.1%), exercising (255; 64.2%), dieting for weight loss (98; 24.7%), dieting for weight maintenance (102; 25.7%), regular dieting before COVID-19 (112; 28.2%), and maintaining exercise after pandemic (194; 48.9%). Other significantly affected healthy behaviors were decreasing food intake (301; 75.8%; P value 0.01) and eating less meat (200; 50.4%; P value 0.00).

Conclusions:

Healthy behavior for weight control during the COVID-19 pandemic was reported by less than half of the study population. Minority (15.6%) engaged in at least one unhealthy or extreme weight loss practice. Healthy behavior was significantly influenced by gender, employment, and educational level.

Translation and validation of an extended German-language version of the Perceived Locus of Causality Questionnaire (PLOCQ-G) in a sample of physical education students

The aims of this study were to translate and validate an extended German-language version of the Perceived Locus of Causality Questionnaire (PLOCQ), a questionnaire that assesses behavioural regulations in the physical education (PE) context. Items assessing integrated regulation were added given that the original PLOCQ omits this factor. The sample consisted of 223 students from different German secondary schools. Psychometric analyses provided support for the six factors and 24-item model. Inter-correlations among the factors predominantly mirrored a simplex-like structure, except for the correlations between introjected and identified regulation and integrated regulation and its adjacent forms of regulation. Construct validity was demonstrated with positive correlations between the autonomous forms of regulation on the one hand and task orientation, perceived competence, and enjoyment on the other. Overall, this study showed that the PLOCQ‑G with six factors and 24 items has good psychometric properties and can be used to assess behavioural regulations in German PE students.

Physical Education and Its Importance to Physical Activity, Vegetable Consumption and Thriving in High School Students in Norway

Earlier research indicates that physical education (PE) in school is associated with positive outcomes (e.g., healthy lifestyle, psychological well-being, and academic performance). Research assessing associations with resilience and thriving indicators, such as the 5Cs of Positive Youth Development (PYD; competence, confidence, character, caring, and connection) is limited and more so in the Norwegian context. The aim of the present study was to investigate associations between PE grade (reflecting students’ effort in theoretical and practical aspects of the subject) and the 5Cs as well as healthy behaviors (physical activity (PA), fruit and vegetable consumption), using cross-sectional data collected from 220 high school students in Norway (M_age = 17.30 years old, SD = 1.12; 52% males). Results from structural equation modelling indicated positive associations between PE grade and four of the 5Cs (competence, confidence, caring, and connection; standardized coefficient: 0.22–0.60, p < 0.05) while in logistic regressions, a unit increase in PE grade was associated with higher likelihood of engaging in PA and vegetable consumption (OR = 1.94; 95% CI = 1.18–3.18 and OR = 1.68; 95% CI = 1.08–2.63, respectively). These significant findings suggest the need for policies and programs that can support effective planning and implementation of PE curriculum. However, further research is needed to probe into the role of PE on youth health and development with representative samples and longitudinal designs.

School-Level Factors within Comprehensive School Health Associated with the Trajectory of Moderate-to-Vigorous Physical Activity over Time: A Longitudinal, Multilevel Analysis in a Large Sample of Grade 9 and 10 Students in Canada

(1) The majority of Canadian youth are insufficiently active, and moderate-to-vigorous physical activity (MVPA) decreases substantially during secondary school. School factors within the comprehensive school health (CSH) framework may help attenuate this decline. This study aimed to examine how youth MVPA changes over a three-year period and evaluate the school characteristics associated with preventing the decline in MVPA over time, guided by the CSH framework. (2) This study uses COMPASS survey data from 78 secondary schools in Ontario and Alberta that participated in Year 2 (2013/14), Year 3 (2014/15), and Year 4 (2015/16), and 17,661 students attending these schools. Multilevel (linear mixed effects) models were used to determine the association between school-level factors and student MVPA (weekly minutes) over time, stratified by gender. (3) Both male and female students had a significant decline in MVPA across the 3 years, with a greater decrease observed among female students. Within the CSH framework, the school's social environment, partnerships, and policies were associated with student MVPA over time, however the specific school factors and directions of associations varied by gender. (4) School-based interventions (e.g., public health partnerships) may help avoid the decline in MVPA observed in this critical period and support student health.

Individual vs. Team Sports-What's the Better Strategy for Meeting PA Guidelines in Children?

There is insufficient evidence from previous studies dealing with structure of sport preferences referring to the interconnection between individual factors (socio-economic status, organized/structured physical activity (PA), location, etc.), although these factors can considerably influence total level of PA as well as the structure of sport preferences. The study investigated associations between PA frequency and specific sports activities according to the intensity with the impact on leisure, sport, and education domain, using data from an international health behavior in school-aged children survey. Participants were fifth and ninth grade students in the Czech Republic (seven schools) and Slovakia (nine schools). The results showed a significant association between intensity in team sports and PA frequency per week. Those who participated in high-intensity team sports were 2.5 times more likely to be more physically active.

The socio-ecological determinants of change in school travel mode over the transition from childhood to adolescence and the association with physical activity intensity

School active travel contributes to young people's physical activity levels, yet the prevalence is low, and declines with age. Based on determinants from the social-ecological model we investigated changes in school travel behaviour over the transition from childhood to adolescence in participants from the baseline and four-year follow-up of the SPEEDY cohort. Descriptive analysis examined how travel behaviours changed and were related to physical activity. Multinomial logistic regression investigated determinants. Some 38% of participants changed travel mode; 66% from active to passive. Passively traveling participants at follow-up showed a decrease in physical activity. Several social-ecological domains were associated with change. Findings suggest multicomponent interventions are required to support active travel in youth.

Association between health literacy and leisure time physical activity among Lithuanian adolescents

Recently, discussion of the potential of health literacy (HL) for health promotion has increased; however, clear evidence illuminating the relationship between adolescents' HL and their physical activity (PA) remains scarce. This study aimed to assess the association between adolescents' HL and leisure time PA. A representative cross-sectional study was conducted with 2,369 Lithuanian adolescents aged 13-16 years. A self-reported questionnaire gathered information regarding HL, leisure time PA, and other confounders (gender, age, family affluence and parents' exercise). Descriptive statistics and the probabilities of being physically active were estimated using logistic regression. The results revealed that almost 60% of the participants were not sufficiently physically active. Having moderate or high levels of HL was positively associated with leisure time PA. Additionally, being male, belonging to a more affluent family, and having a father who exercise were significant predictors of adolescents' leisure time PA. This study revealed that moderate and high HL positively related to leisure time PA among Lithuanian adolescents. The study results highlighted the importance of encouraging schoolchildren's PA and including HL promotion in a school curriculum.

Prospective analysis of physical activity levels and associated fitness factors amid COVID-19 pandemic and social-distancing rules. A special focus on adolescents

Objective

Physical activity is a significant health determinant and is likely to be influenced by social-distancing rules imposed by authorities during the COVID-19 pandemic. This study explored gender-based differences in physical activity levels (PALs) and associated factors amid COVID-19 pandemic in adolescents.

Methods

In this prospective analysis, 112 healthy adolescents (15.63 ± 1.21 years) participated. They were assessed at the baseline (before the announcement of COVID-19 as a global pandemic) for anthropometry, fitness status, and PALs (baseline-PALs), and next at the follow-up (three months of imposed social-distancing rules) for PALs (follow-up-PALs) over an internet-based platform through the Physical Activity Questionnaire for Adolescents.

Results

A significant PALs decline was evidenced for the whole sample (P < .001) and such a decline was predominantly affected by significant PALs reduction among males (P < .001) rather than in females (P = .06). The fitness variables (explosive power, muscle endurance, flexibility, and aerobic endurance) were consistently positively correlated with the baseline- and follow-up-PALs in both genders with particularly prominent associations of PALs with explosive power and aerobic endurance.

Conclusion

Physical literacy is necessary for PALs preservation, given the remarkable PALs decreases among adolescents during challenging circumstances such as the COVID-19 pandemic.

Physical Activity, Fitness, and Executive Functions in Youth: Effects, Moderators, and Mechanisms

Over the last decade, a growing body of research has examined the link between physical activity, fitness, and cognitive function in children and adolescents. Physical activity experimental research conducted with children and adolescents has identified selectively greater effects for tasks requiring higher order executive functions. As such, the primary aim of our chapter is to provide an overview of findings from systematic reviews and meta-analyses that have examined the effects of physical activity on measures of executive function in child and adolescent populations. We begin our chapter with definitions of key concepts associated with physical activity, fitness and cognitive function. We then provide a synthesis of systematic reviews and meta-analyses that have examined the acute and chronic effect of physical activity on EFs. Following this, we discuss the quantitative (e.g., time, intensity) and qualitative (e.g., type) characteristics of physical activity that may moderate effects. The next section focuses on the neurobiological, psychosocial and behavioral mechanisms responsible for the effect of physical activity on executive functions. We conclude by highlighting the limitations of the existing evidence base and providing recommendations for future research.

Lifestyle Sports and Physical Education Teachers’ Professional Development in the United Kingdom: A Qualitative Survey Analysis

Lifestyle sports can contribute to national sport and physical activity agendas. However, schools in the United Kingdom (UK) have generally resisted the implementation of such activities within the physical education (PE) curriculum. This may stem from PE teachers’ limited knowledge and restricted engagement with lifestyle sports continuing professional development (CPD), coupled with the dominance of traditional team sports within the PE curriculum. Consequently, the aim of this research was to explore the opportunities and challenges PE teachers in the UK encounter when delivering lifestyle sports, in addition to understanding their current professional development needs to enhance their practice. Data were collected via an online qualitative survey involving 53 UK-based PE teachers. Following a reflexive thematic analysis process, three themes were developed: (1) PE teachers’ understanding, conceptualisation, and delivery of lifestyle sports; (2) challenges to delivering lifestyle sports within the PE curriculum; and (3) the learning needs and CPD preferences of PE teachers. Findings indicated that the participants possessed diverse conceptualisations of lifestyle sports, while faced with logistical, contextual, and personal factors which impacted their practice. Furthermore, the participants outlined their preferences towards lifestyle sports CPD and the challenges restricting their engagement with learning opportunities. Recommendations for future research are discussed.

Adaptation, Student Participation and Gradual Withdrawal by Researchers as Sustainability Strategies in the High School-Based Young and Active Intervention: School Coordinators' Perspectives

Ensuring the sustainability of school-based public health intervention activities remains a challenge. The Young and Active (Y&A) intervention used peer-led workshops to promote movement and strengthen students' sense of community in 16 Danish high schools. Peer mentors inspired first-year students to implement movement activities. To support sustainability, we applied a three-year stepwise implementation strategy using university students as peer mentors in year 1 and senior high school students in the following two years. This study explores the sustainability potential of Y&A, focusing on school coordinators' reflections on the intervention's fit to their schools and the student-driven approach, and we assess the three-step implementation strategy. The study is based on telephone interviews with coordinators (n = 7) from schools that participated in all three years and participant observations of four workshops (a total of approximately 250 participating students). Results were generated through an abductive analysis. Seven schools continued the intervention throughout the three years and adapted it to fit their priorities. The student-driven approach was perceived to be valuable, but few student-driven activities were initiated. Teacher support seemed crucial to support students in starting up activities and acting as peer mentors in workshops. The three-step implementation strategy proved valuable due to the peer-approach and the possibility of gradual adaptation. In future similar initiatives, it is important to address how the adequate staff support of students can be facilitated.

Daily physical activity patterns in children and adolescents with inflammatory bowel disease

BACKGROUND

The aim of this study was to assess PA patterns among children and adolescents with inflammatory bowel disease (IBD).

METHODS

Sixty participants with IBD (42 Crohn's disease [CD], 10 ulcerative colitis [UC], and 8 IBD-unclassified [IBD-U], 30 male patients) in remission (n = 45) or with mild disease (n = 15) were compared with 60 healthy age- and sex-matched controls. Each participant wore a triaxial accelerometer during 4 consecutive days for objective daily PA quantification.

RESULTS

Overall, there was no significant difference in daily PA patterns between patients with IBD and healthy controls, with 31.7% of patients with IBD and 38.3% of healthy controls fulfilling the recommendation of 60 min of moderate-to-vigorous physical activity (MVPA) daily (NS). Male patients with IBD spent significantly less time in MVPA compared with matched healthy controls (mean difference, 16.2 min day^-1; p < 0.05). No difference was observed for female patients with IBD. No difference in sedentary pattern between male patients with IBD and controls was found.

CONCLUSIONS

Children and adolescents with inactive or mildly active IBD have similar PA patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. By far, most patients with IBD do not fulfill the MVPA recommendations for health benefits.

IMPACT

There is few data on PA patterns in pediatric patients with IBD. Methodological issues to assess PA limit the strengths of these studies. Pediatric IBD patients with inactive or mildly active IBD have similar physical activity patterns compared with healthy controls, except for male patients who have reduced moderate-to-vigorous PA. Most patients with IBD do not fulfill the MVPA recommendations for health benefits.

Associations between the School Environment and Physical Activity Pattern during School Time in Swedish Adolescents

Knowledge about associations between school-based initiatives and physical activity patterns is limited. The purpose of this paper was to examine associations between factors in the school environment, physical activity and sedentary time during school time. The cross-sectional study included 1139 adolescents aged 13–14 from 34 schools. Physical activity and sedentary time were measured using hip-worn accelerometers. Factors in the school environment included health policy, a mobile phone ban during breaks, organized physical activities during breaks and activity breaks during lessons reported by teachers. The frequency and duration of breaks and physical education (PE) lessons were collected from school schedules. The results showed significant associations between health policy (β = 3.87, 95% confidence interval (CI): 2.37, 5.23), the mobile phone ban (β = 2.51, 95% CI: 1.29, 3.94) and PE; total duration (β = 0.08, 95% CI: 0.05, 0.11), average duration (β = 0.08, 95% CI: 0.01, 0.13) and frequency (β = 1.73, 95% CI: 0.50, 3.04) and moderate-vigorous physical activity. There were negative associations between health policy (β = −6.41, 95% CI: −10.24, −2.67), the mobile phone ban (β = −3.75, 95% CI: −7.25, −0.77) and PE; total duration (β = −0.15, 95% CI: −0.23, −0.08) and average duration (β = −0.14, 95% CI: −0.27, −0.03) and time spent sedentary. Adolescents attending schools with health policies, mobile phone bans and more time for PE showed higher levels of physical activity and lower sedentary time.

Prevalence and Trends of Physical Activity in Thai Children and Young People: Pooled Panel Data Analysis from Thailand's Surveillance on Physical Activity 2012-2020

This study aims to describe the level and trends of physical activity (PA) in Thai children and young people and examine PA changes during transitional periods. Employing nine rounds of Thailand's Surveillance on Physical Activity (SPA) 2012-2020, this study pooled three sets of data and included children and young people aged 6-17 years in the analysis: 1595 in SPA2012-2016, 1287 in SPA2017-2019, and 853 persons in SPA2020. Face-to-face interviews were conducted in five regions, 13 provinces, and 36 villages in SPA2012-2019, whereas an online survey was administered in all provinces in SPA2020. The prevalence of sufficient moderate-to-vigorous PA (MVPA) among Thais aged 6-17 years ranged from 19.0 percent to 27.6 percent, with a significant drop during the period of COVID-19 spread in 2020. The average daily MVPA ranged from 46 to 57 min and dropped to 36 min during the pandemic. Boys were consistently more active than girls in all nine rounds of the SPA, and girls had more difficulty in maintaining or improving their PA level. A significant increase in the proportion of Thai children and young people with sufficient MVPA was observed during their transition from late primary to early secondary school grades.

Biological and socioeconomic factors as moderator in relationship between leisure-time physical activity and cardiometabolic risk in adolescents from southern Brazil

BACKGROUND

Given the important repercussions that sociodemographic factors can have on physical activity, especially in the field of leisure, and cardiometabolic risk, it seems relevant to analyze the implications of these variables on the relationship between physical activity in leisure time (LTPA) and cardiometabolic risk. In this sense, the present study aims to verify the moderating role of biologic and socioeconomic factors in the relationship between LTPA and cardiometabolic risk in adolescents in southern Brazil.

METHODS

Cross-sectional study that included 1596 adolescents selected at random (58.2% girls), aged between 10 and 17 years. LTPA, biological and socioeconomic factors were assessed using a self-reported questionnaire and the cardiometabolic risk score (total cholesterol/HDL-c ratio, triglycerides, fasting glucose, systolic blood pressure, and waist circumference, considering the participant's age and sex) was included as an outcome. Associations and moderations were tested by multiple linear regression models.

RESULTS

It was observed a positive interaction of LTPA and sex (p = 0.048) and LTPA and school system (p = 0.037), and negative interaction of LTPA and skin color (p = 0.040), indicating that these factors were moderators in the relationship between LTPA and clustered cardiometabolic risk score (cMetS) in adolescents. A reduction in cardiometabolic risk was observed according to the increase in weekly minutes of LTPA among boys, non-white adolescents, and students from municipal schools.

CONCLUSIONS

The association between LTPA and cardiometabolic risk was moderated by sex, skin color, and school system in adolescents from southern Brazil.

Influence of Physical Self-Concept and Motivational Processes on Moderate-to-Vigorous Physical Activity of Adolescents

There is a growing concern about the increasing decline in physical activity among adolescents. In the search for variables that may be related to physical activity, this study examined the influence of physical self-concept on objectively measured moderate-to-vigorous physical activity (MVPA) of adolescents through the mediation of the needs satisfaction and two types of autonomous motivation, for academics and for physical education. Data were collected from 618 students (301 boys and 317 girls) aged 10–14 years from 24 secondary schools in Spain. The path analysis results showed that physical self-concept positively predicted needs satisfaction and this, in turn, was positively and significantly related to the two types of autonomous motivation. Finally, only the autonomous motivation for physical education significantly and positively predicted the adolescents’ MVPA. Our findings showed that there was no evidence of an indirect effect of physical self-concept on MVPA. The results are discussed along the lines of the self-determination theory, through the analysis of the role of physical self-concept in increasing adolescents’ physical activity.

Kicking goals: Exploring the experiences of girls who play Australian Rules football

ISSUE ADDRESSED

Increasing physical activity of adolescent girls is a key priority for health promotion, as their physical activity levels are generally lower than boys. This study aims to understand the experiences of adolescent girls who play Australian Football League Women's (AFLW) football and to explore girls' pathways to playing football. Understanding how AFLW and gender norms/stereotypes influence girls' experiences and self-perceptions was a key focus.

METHODS

A qualitative description design and purposive sampling were used. Six adolescent girls aged 11-17 that play football in urban Victoria, Australia participated. Short interview survey questions covering demographic and football pathway information were administered prior to online one-on-one interviews. Interviews lasted 30-45 minutes. Questions were framed broadly, open-ended and non-directive (some using image prompts). Data were analysed using thematic analysis.

RESULTS

The results cover four themes: (a) Self-perception-participants presented with positive self-perceptions, (b) Social support-a supportive team and exposure to women playing football, and family support/involvement, were encouraging factors in pathways to playing football, (c) AFLW role models-were positive influences on participants' experience and self-perceptions and (d) Influence of gender norms/stereotypes-participant self-perceptions displayed conforming and non-conforming features of gender norms/stereotypes. Participants reported exposure to sexist commentary about girls in sport through social media and peers but instead of being discouraged, most used it as motivation or empowerment, while others were dismissive.

CONCLUSIONS

Findings suggest increased media coverage of AFLW players may be beneficial. Education programs/initiatives which i) involve AFLW role models and ii) encourage family friendly club environments and team bonding spaces are recommended. SO WHAT?: Findings indicate that adolescent girls can thrive in their football experience, which could increase feelings of empowerment and foster positive self-perceptions, contributing to overall health. Further research in this area is recommended to expand on and strengthen our study findings.

Physical Exercise and Psychological Distress: The Mediating Roles of Problematic Mobile Phone Use and Learning Burnout among Adolescents

Psychological distress among adolescents adversely affects their development and negatively impacts them later in life. The aim of the present study was to determine whether an association exists between physical exercise and psychological distress and to explore the roles of problematic mobile phone use and learning burnout with respect to this association. A total of 2077 Chinese adolescents were evaluated by using the Physical Exercise Questionnaire, the Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use, the Learning Burnout Questionnaire, and the Depression Anxiety Stress Scale-21. A serial multiple mediation model was constructed using the SPSS PROCESS macro. The results showed that physical exercise was negatively associated with psychological distress in this Chinese adolescent population. Serial multiple mediation analysis revealed that problematic mobile phone use and learning burnout both independently and serially mediated the association between physical exercise and psychological distress. These findings provide evidence suggesting that increased attention should be given to problematic mobile phone use and learning burnout when establishing and implementing specific strategies that leverage greater participation in physical exercise to decrease psychological distress in adolescents.

Concordance Between the Weight of Spanish Adolescent Soccer Players, Their Self-Perceived Weight, and Their Weight as Perceived by Their Parents

PURPOSE

In the context of soccer clubs, to analyze the concordance between players' actual weight, their self-perceived weight, and their weight as perceived by their parents; to determine which variables might explain the presence of concordance between parents' perception of adolescents' weight and their actual weight. Design and study: A cross-sectional study involving 330 soccer players aged between 13 and 16. Data on personal characteristics of adolescents and parents were analyzed, as well as parents' perceptions of adolescents' weight status and their self-perception. A descriptive analysis of the personal characteristics of the sample (adolescents and parents) and an analysis of the variables explaining the presence of concordance between the parents' perception of adolescents' weight and their actual weight were performed.

RESULTS

19% of the adolescents were overweight and 3.4% were obese. The concordance between parents' perceptions of players' weight and players' actual weight was weak. The concordance between adolescents' self-perceived weight and their actual weight was moderate. The difference in BMI scores according to presence or absence of concordance was statistically significant: these scores were higher in the absence of concordance. Discordance between adolescents' weight and their parents' perception of their weight was associated with parents having lower levels of education.

CONCLUSION

A high percentage of parents and players misperceived their actual weight. This discrepancy was associated with higher BMI scores for adolescents.

PRACTICE IMPLICATIONS

Nurses should include promotion of accurate weight perception in educational interventions on excess weight.

Self-Report Motor Competence in Adolescents Aged 12-18 Years in Regional and Rural Victoria (Australia)

Background: Poor motor skills are an increasing issue for adolescents in our local communities. In regional Victoria, almost 20% of children starting school in 2018 were considered at risk or developmentally vulnerable in the domain of physical health and wellbeing. Purpose: The aim of the current study was to examine factors (how adolescents perceive their fine and gross motor skills, activities of daily living, comparison to peers) of motor competence that may be important to adolescents in regional Victoria, Australia, using the Adolescent Motor Competence Questionnaire (AMCQ). Methods: A sample of 183 Australian adolescents ([138 females (M_age = 15.59 years, SD = 1.56); 45 males, (M_age = 15.82 years, SD = 1.95); 12-18 years old] completed the AMCQ. Results: The mean AMCQ score was 87.86 (SD = 7.55), with no significant difference between males (M = 89.67 SD = 7.29) and females [M = 87.28 SD = 7.56; t (181 = 1.86 p =.065)]. A Principal Component Analysis (PCA), extracted five factors (Eiqenvalue of 1.389) explaining 43.46% of variance, representing, Ball Skills and Kinesthesis; Activities of Daily Living; Fine Motor and Gross Motor; Proprioception and Exteroception; Public Performance. Conclusion: The results highlight key factors important in describing an adolescent's motor competence within regional Victoria. With physical health a priority in local communities, understanding these factors is an important first, that which may inform development of physical activity interventions for adolescents.

Age-related change in sedentary behavior during childhood and adolescence: A systematic review and meta-analysis

Sedentary behaviors are highly prevalent in youth and may be associated with markers of physical and mental health. This systematic review and meta-analysis aimed to quantify the age-related change in sedentary behavior during childhood and adolescence. Ten electronic databases were searched. Inclusion criteria specified longitudinal observational studies or control group from an intervention; participants aged ≥5 and ≤18 years; a quantitative estimate of the duration of SB; and English language, peer-reviewed publication. Meta-analyses summarized weighted mean differences (WMD) in device-assessed sedentary time and questionnaire-assessed screen-behaviors over 1-, 2-, 3-, or more than 4-year follow-up. Effect modification was explored using meta-regression. Eighty-five studies met inclusion criteria. Device-assessed sedentary time increased by (WMD 95% confidence interval [CI]) 27.9 (23.2, 32.7), 61.0 (50.7, 71.4), 63.7 (53.3, 74.0), and 140.7 (105.1, 176.4) min/day over 1-, 2-, 3-, and more than 4-year follow-up. We observed no effect modification by gender, baseline age, study location, attrition, or quality. Questionnaire-assessed time spent playing video games, computer use, and a composite measure of sedentary behavior increased over follow-up duration. Evidence is consistent in showing an age-related increase in various forms of sedentary behavior; evidence pertaining to variability across socio-demographic subgroups and contemporary sedentary behaviors are avenues for future research.

The Importance of Parents' Income and Education Level in Relation to Their Preschool Children's Activity Level at Leisure

Previous research indicate that socioeconomic status positively corresponds with adults’ and adolescents’ physical activity levels. This study investigated the relationship between parents’ education and income, and preschool children’s physical activity level. A total of 244 Norwegian preschool children aged four to six and their parents were enrolled in the study. The children wore an Actigraph GT1M accelerometer for seven consecutive days to measure their physical activity level. Parents completed a questionnaire that provided information about their education level and income level. To examine the relationship between the parents’ education and income and their children’s physical activity level at leisure, the Kruskal-Wallis H test was conducted. The results revealed that neither mothers’ nor fathers’ education level or income, were associated with their children’s minutes in moderate to vigorous physical activity (MVPA) at leisure. The preschool curriculum of Norway may be one explanation why socioeconomic status was not linked to physical activity in this study. Another possibility is that this study was limited to full-time students with two parents. More research is needed to determine whether parent income or education is linked to physical activity among more diverse or older children in Norway.

Age-varying Bi-directional Associations Between Momentary Affect and Movement Behaviors in Children: Evidence From a Multi-wave Ecological Momentary Assessment Study

BACKGROUND

The bi-directional associations between affective states and movement behaviors (e.g., physical activity, sedentary behavior) have been observed in children. It is unclear if the strength of these bi-directional associations varies with age as children transition from childhood to adolescence.

PURPOSE

This multi-wave ecological momentary assessment (EMA) study investigates the acute time-varying associations between affect and movement behaviors among youth.

METHODS

Children (N = 195, baseline mean age = 10.72, range = 8-12 years, mean BMI-z = 0.49, 51% female) participated in a six-wave EMA study across three years. Each EMA survey captured momentary positive and negative affect. Time spent in moderate-to-vigorous physical activity (MVPA) and sedentary time in the 15-min window before and after each EMA survey was calculated using accelerometry data. Time-varying effect models (TVEM) examined the acute bi-directional associations between momentary positive/negative affect and MVPA/sedentary time across ages 8 to 14.

RESULTS

Children provided 14,246 valid activity-matched EMA surveys across all waves. TVEM plots revealed that the directionality and the strength (time-varying slopes) of associations between momentary affect and activity levels vary across ages. Positive affect was associated with higher MVPA levels and lower sedentary time at younger ages, whereas negative affect linked to lower MVPA levels and more sedentary time at older ages.

CONCLUSIONS

The acute associations between momentary affect and (in)activity levels may vary as a function of children's age. Applying TVEM to intensive longitudinal data could provide valuable information for developing age-tailored interventions that promote healthy lifestyles among children and adolescents.

Are Self-Efficacy and Perceived Environmental Characteristics Determinants of Decline in Physical Activity Time?

CONTEXT

This study analyzed whether self-efficacy (SE) and perceived environmental characteristics (EC) are determinants of the decline in physical activity (PA) time in adolescents.

METHODS

This used longitudinal observational approach, with 4 years of data collection, involving 355 adolescents (57.7% girls and 42.3% boys), average age of 11.8 years (0.1 y), from João Pessoa, Paraiba, Brazil. SE and EC were measured by scales and PA by a questionnaire. Ordinal logistic regression was used to associate SE and EC with a decline in PA.

RESULTS

There was a linear trend toward a decrease in average PA duration (58.3 [13.7] min/wk/y) and a rise in average access to places for PA (point per year) (0.6 [0.1]), urban safety (0.2 [0.1]), and traffic safety scores (0.5 [0.1]). The results of multivariable analysis indicated that SE and EC were not associated with the decline in PA.

CONCLUSION

There was a decline in PA time, and SE and perceived EC were not determinants of this decline.

Risk factors and risk profiles for neck pain in young adults: Prospective analyses from adolescence to young adulthood-The North-Trøndelag Health Study

The objective was to investigate risk factors and risk profiles associated with neck pain in young adults using longitudinal data from the North-Trøndelag Health Study (HUNT). Risk factors were collected from adolescents (13-19 years of age), and neck pain was measured 11 years later. The sample was divided into two: Sample I included all participants (n = 1433), and Sample II (n = 832) included only participants who reported no neck/shoulder pain in adolescence. In multiple regression analyses in Sample I, female sex (OR = 1.9, 95% CI [1.3-2.9]), low physical activity level (OR = 1.6, 95% CI [1.0-2.5]), loneliness (OR = 2.0, 95% CI [1.2-3.5]), headache/migraine (OR = 1.7, 95% CI [1.2-2.6]), back pain (OR = 1.5, 95% CI [1.0-2.4]) and neck/shoulder pain (OR = 2.0, 95% [CI 1.3-3.0]) were associated with neck pain at the 11-year follow-up. Those with a risk profile including all these risk factors had the highest probability of neck pain of 67% in girls and 50% in boys. In Sample II, multiple regression analyses revealed that female sex (OR = 2.2, 95% CI [1.3-3.7]) and perceived low family income (OR = 2.4, 95% CI [1.1-5.1]) were associated with neck pain at the 11-year follow-up. Girls and boys with a perceived low family income had a 29% and 17% higher probability of neck pain than adolescents with a perceived high family income. The risk profiles in both samples showed that co-occurrence of risk factors, such as headache/migraine, neck/shoulder pain, back pain, low physical activity level, loneliness, and perceived low family income cumulatively increased the probability of neck pain in young adulthood. These results underline the importance of taking a broad perspective when studying, treating, and preventing neck pain in adolescents.

The development and initial validation of the Health and Reproductive Survey (HeRS)

Background:

Due to the diversity in profiles associated with the female reproductive cycle and their potential physiological and psychological effects, monitoring the reproductive status of exercising females is important from a practical and research perspective. Moreover, as physical activity can influence menstrual function, the effects of physical activity energy expenditure on reproductive function should also be considered.

Aim:

The aim of this study was to develop and establish initial face and content validity of the Health and Reproductive Survey (HeRS) for physically active females, which is a retrospective assessment of menstrual function from menarche (first menstruation) to menopause (cessation of menstruation).

Methods:

Face validity was evaluated qualitatively, and the initial content validity was established through a principal component analysis. The face validity process was completed by 26 females aged 19–67 years and the content validity was established through a survey sent to a convenience sample of 392 females, of which 230 females (57.9% and aged 18–49 years) completed the survey.

Results:

The revisions made following the face validation improved the understanding, flow, and coherence of the survey. The principal component analysis indicated that, at a minimum, the survey measures these constructs: menstrual cessation and associated moderators, athletic participation and performance levels (as associated with menstruation change and the menstrual cycle), age and menstrual cessation, hormonal contraception (“birth control”), and menarche and associated moderators.

Conclusion:

The Health and Reproductive Survey (HeRS) is a partially validated tool that can be used by researchers to characterize the menstrual status of physically active females relative to their physical activity status.