The impact of life stresses on physical activity participation during adolescence: A 5-year longitudinal study

Results from the Lebanese 2022 report card on physical activity for children and youth

Objective

The Lebanese Active Healthy Kids Work Group (LAHKWG) synthesized literature published on physical activity (PA) indicators among ages 5- to 17- year-olds, using a recommended harmonized process by the Active Healthy Kids Global Alliance (AHKGA), to explore Lebanon's performance since its previous report card publication.

Methods

Peer reviewed literature, national surveys, and gray literature published since 2017, on 10 common AHKGA and two LAHKWG recommended indicators were examined. Common indicators included overall PA, organized sport and PA, active play, active transportation, community and environment, sedentary behaviors, physical fitness, family and peers, school, and government. LAHKWG recommended indicators were sleep and weight status. LAHKWG members reviewed 764 records, of which 28 were selected for full review. A grade was assigned for each indicator using AHKGA's grading rubric and established benchmarks on data from nationally representative samples for children and youth.

Results

Data from one nationally representative sample were available for ages 13–17 years (i.e., no data <13 years). Five indicators received “Incomplete” (organized sport and PA; active Play; physical fitness; family and peers; community and environment); overall PA received a D-; active transportation and sleep received a D+; school and government received a D; sedentary behaviors received a C; and weight status received a B-.

Conclusion

The LAHKWG strongly encourages stakeholders to take concrete actions towards prioritizing PA promotion at a national level especially in the education sector. Offering more quality PA opportunities for Lebanese children and youth will be beneficial for their physical and mental health in any context.

Autonomous motivation and action planning are longitudinally associated with physical activity during adolescence and early adulthood

We examined the associations of autonomous motivation, controlled motivation, and physical activity (PA) planning with PA participation over six years across the adolescent-to-adult transition. Participants from the NEXT Generation Health Study, a nationally representative cohort study of U.S. 10th graders (N=2785), completed surveys yearly from 2010 to 2016 (four years post-high school). This study used data from Waves 2 (W2) through 7 (W7). Data were analyzed using growth models accounting for the complex survey design and controlling for sex, race/ethnicity, and body mass index. A piecewise growth model with two pieces (Piece 1: W2-W4; Piece 2: W4-W7) indicated that PA declined during late adolescence (W2-W4) (b=-0.31, β=-0.22, p<.001), but did not decline after the transition into early adulthood (W4-W7) (b=-0.08, β=-0.04, p=.052). Autonomous motivation was positively associated with PA at all waves (b=0.23-0.33, β=1.90-4.37, p<.001). Controlled motivation was only positively associated with PA at W3 (12th grade) (b=0.13, β=1.54, p=.011). PA planning varied significantly between individuals and significantly predicted PA (b=0.44, β=0.21, p<.001). Although PA decreased significantly during late adolescence, PA did not decrease significantly after transitioning into early adulthood (one to four years post-high school). Elevated autonomous motivation and PA planning were consistently and significantly associated with higher PA, suggesting that these may be useful intervention targets during this adolescent-to-adult transition.

A Qualitative Study of Stress and Coping to Inform the LEADS Health Promotion Trial for African American Adolescents with Overweight and Obesity

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70–0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.

Psychological Stress and Lowered Physical Activity Enjoyment in Adolescents With Overweight/Obesity

PURPOSE

The purpose of this study was 2-fold: 1) to determine the cross-sectional associations between psychological stress, physical activity enjoyment, and physical activity participation [moderate-to-vigorous physical activity (MVPA), total physical activity (TPA)]; and 2) to determine the moderating effect of physical activity enjoyment on the associations between stress, MVPA, and TPA in adolescents with overweight/obesity.

DESIGN

Cross-sectional, secondary data analysis of the Health and Culture Project and the Stress, Obesity, and Diabetes in Adolescents study.

SAMPLE

One hundred and ten adolescents (73% female; 65.4% non-white; age 15.8 ± 1.9 years) with overweight/obesity (BMI percentile ≥ 85th percentile) were included in this analysis.

MEASURES

Psychological stress was assessed using the Perceived Stress Scale (PSS-14); enjoyment was measured via the Physical Activity Enjoyment Scale; and MVPA and TPA were objectively measured using accelerometry over a minimum of 4 days.

RESULTS

Higher perceived stress was associated with lower physical activity enjoyment (β = -0.41 ± 0.15; p = 0.008). Stress was not associated with MVPA or TPA (ps > 0.05), nor was enjoyment a significant moderator in the associations between stress and MVPA or stress and TPA (p_interaction > 0.05).

CONCLUSIONS

These findings suggest that psychological stress is associated with lower physical activity enjoyment among adolescents with overweight/obesity. Longitudinal studies are needed to understand the long-term effects of stress on psychological factors that may serve as antecedents to physical activity participation among adolescents with overweight/obesity.