Associations between the school environment and adolescent girls' physical activity

Ecological correlates of sport and exercise participation among Thai adolescents: A hierarchical examination of a cross-sectional population survey

BACKGROUND

Understanding factors influencing adolescents' sport/exercise participation (S/EP) is vital to developing effective interventions, but currently, evidence from less developed countries is limited. The purpose of this study was to examine correlates of S/EP across individual, interpersonal, and environmental levels in a nationally representative sample of Thai adolescents.

METHODS

Data from 4617 Thai adolescents aged 14-17 years old were obtained from recruited schools across Thailand. Data on S/EP (outcome variable), and psychosocial, home, and community environment covariates were collected from individual adolescents using the Thailand Physical Activity Children Survey, Student Questionnaire. School environmental data were collected at the school level using a School Built Environment Audit. Hierarchical regressions taking into account school clustering effects were applied for data analysis.

RESULTS

At the individual level, age and body mass index were independently and strongly correlated with S/EP. Adolescents with high preference for physical activity (PA) (odd ratio (OR) = 1.71, p < 0.001) and at least a moderate level of self-efficacy (OR = 1.33, p = 0.001) were more likely to have high S/EP. At the interpersonal level, adolescents whose parents joined their sports/exercise at least 1-2 times/week (OR = 1.36, p = 0.003) received ≥3 types of parental support (OR = 1.43, p = 0.005) and who received siblings' (OR = 1.26, p = 0.004) and friends' (OR = 1.99, p < 0.001) support had a greater chance of high S/EP. At the environmental level, adolescents' S/EP was greater when there were at least 3-4 pieces of home sport/exercise equipment (OR = 2.77, p = 0.003), grass areas at school (OR = 1.56, p < 0.001), and at least 1-2 PA facilities in the community (OR = 1.30, p = 0.009).

CONCLUSION

Multiple factors at different levels within an ecological framework influencing Thai adolescents' S/EP were generally similar to those found in developed countries, despite some differences. For those interested in promoting and supporting Thai adolescents' engagement in sports/exercise, further exploration of the influence of self-efficacy and attitude toward PA is required at the individual level; parental and peer support at the interpersonal level; and home sport equipment, school grass areas, and neighborhood PA facilities at the environment level.

How the COVID-19 Pandemic Has Changed Adolescent Health: Physical Activity, Sleep, Obesity, and Mental Health

The purpose of this study is to provide essential data for the establishment of education and policy for the formation of healthy lifestyles of adolescents in the future by analyzing the patterns of changes in society due to the prolonged COVID-19 in the physical activities, sleeping habits, obesity, and mental health of Korean adolescents. To this end, a total of 147,346 adolescents were selected and analyzed according to the purpose of the study in the 2018 (14th), 2019 (15th), and 2020 (16th) raw data of the “Youth Health Behavior Online Survey,” an annual national approval statistical survey conducted by a Korean government agency. The study examined changes in the physical activity, obesity, sleep, and mental health of Korean adolescents due to COVID-19. The physical activity rate of Korean adolescents in 2019 decreased by 5.3% from 2018. In addition, the physical activity rate in 2020 decreased by 2.1% compared to 2019. It was found that physical activity steadily decreased (p < 0.001). The obesity rate increased by 0.9% in 2019 compared to 2018 and by 1.8% in 2020 compared to 2019. Although the obesity rate steadily increased, it was found that it was accelerated due to COVID-19 (p < 0.001). Looking at the subjective sleep satisfaction rate of Korean adolescents, in 2019, it was 0.1% lower than in 2018, while in 2020, when COVID-19 began, it increased by 3.5% compared to 2019. It was found that satisfaction with sleep increased after COVID-19. Finally, the mental health characteristics of Korean adolescents by year were divided into stress and depression. Stress decreased by 1% compared to 2019 and 2018 and by 6.2% compared to 2020 and 2019. Depression increased by 1% in 2019 compared to 2018 and decreased by 3.4% in 2020 compared to 2019. In other words, stress and depression decreased after COVID-19. In 2020, when COVID-19 occurred, it was confirmed that there was a change in the health behavior of adolescents compared to 2018 and 2019. Therefore, active responses from schools, families, and communities are required to foster healthy lifestyle habits in social changes such as COVID-19.

An unsupervised machine learning approach to evaluate sports facilities condition in primary school

Sports facilities have been acknowledged as one of the crucial environmental factors for children’s physical education, physical fitness, and participation in physical activity. Finding a solution for the effective and objective evaluation of the condition of sports facilities in schools (SSFs) with the responding quantitative magnitude is an uncertain task. This paper describes the utilization of an unsupervised machine learning method to objectively evaluate the condition of sports facilities in primary school (PSSFC). The statistical data of 845 samples with nine PSSFC indicators (indoor and outdoor included) were collected from the Sixth National Sports Facility Census in mainland China (NSFC), an official nationwide quinquennial census. The Fuzzy C-means (FCM) algorithm was applied to cluster the samples in accordance with the similarity of PSSFC. The clustered data were visualized by using t-stochastic neighbor embedding (t-SNE). The statistics results showed that the application of t-SNE and FCM led to the acceptable performance of clustering SSFs data into three types with differences in PSSFC. The effects of school category, location factors, and the interaction on PSSFC were analyzed by two-way analysis of covariance, which indicated that regional PSSFC has geographical and typological characteristics: schools in the suburbs are superior to those in the inner city, schools with more grades of students are configured with better variety and larger size of sports facilities. In conclusion, we have developed a combinatorial machine learning clustering approach that is suitable for objective evaluation on PSSFC and indicates its characteristics.

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.

A quantitative assessment of school environment as viewed by teachers

Background

There is evidence suggesting that the school environment does have prominent contributions to the rise of childhood obesity.

Aim

The objective of this study was to assess the school environment by interviewing the teachers and compare the school environment score between rural and urban schools in Terengganu, Malaysia.

Methods

Thirty-two teachers from 16 primary schools in Terengganu were interviewed using a set of validated Malay version “School Environmental Mapping” questionnaire. A total of 76 items consisting of four domains of school environment factor: physical (what is available) with 41 items; economic (what the costs are) with nine items; political (what the rules are) with nine items; and socio-cultural (what the attitudes and beliefs are) with 17 items. Every item was questioned using an initial closed question followed by an open question when the criteria were not met or need further information regarding those particular items.

Results

The present study revealed that the school environment of school in state of Terengganu is still low and not satisfied. Based on the schoolteacher's information and observation, there are significant barriers to promoting healthy eating and physical activity at school e.g. limited financial and budget allocation; lack of school facilities; lack of manpower to organise and monitor the programme; lack of participation and cooperation from parents; and no enforcement and serious action from authorized personnel on street hawkers near the school. This is reflected by the score achieved for 16 schools in Terengganu was only 63.05%. The political environment indicated the highest score among the domains, which was 77.78%, whereas, the lowest score was an economic environment (50.00%). Upon comparing between the urban and rural areas, the present study reported that there was a significant difference between school settings (p < 0.001) for an overall school environment, in which the rural areas had a significantly higher score than urban counterparts (64.86% vs 59.34%, p < 0.001). For each domain of the school environment, the findings showed that only two domains (physical and political environment) were significantly different between school settings.

Conclusion

This study revealed that the level of a healthy school environment among schools in both settings is still not satisfied. Addressing the obesogenic elements of school environments is one of the strategies in prevention since the school environments exert a great influence on children's behaviour.

Association between the school environment and children's body mass index in Terengganu: A cross sectional study

With the on-going interest in implementing school policies to address the problem of childhood obesity in Malaysia, there is urgent need for information about the association between school environment and children’s weight status. This study aims to investigate the association between school environmental factors (physical, economic, political and sociocultural) with BMI of school children in Terengganu. The school environment factors were assessed using a set of validated whole-school environmental mapping questionnaires, consisting of 76 criteria with four domains; physical environment (41 criteria), economic environment (nine criteria), political environment (nine criteria) and sociocultural environment (17 criteria). This involved face-to-face interview sessions with 32 teachers from 16 schools (eight rural and eight urban). In addition, 400 school children aged between 9 and 11 years of the selected schools were assessed for BMI (WHO 2007 reference chart), dietary intake (food frequency questionnaire (FFQ)) and physical activity level (physical activity questionnaire for children (PAQ-C)). Multiple regression was used to examine the association between school environment factors and BMI of the school children. Seven school environment criteria were found to be associated with BMI of school children when it was adjusted for calorie intake and physical activity level. About 33.4% of the variation in BMI of school children was explained by health professional involvement, simple exercise before class, encouragement to walk/ride bicycle to/from school, no high-calorie food sold, healthy options of foods and drinks at tuck shop, availability of policy on physical activity and training teacher as a role model. Policy makers should make urgent actions to address the obesogenic features of school environments. It should strive towards setting up healthy school environment and improving school curricula to promote healthy behaviours among the school children.

Adolescent Girls’ Perceptions of Physical Activity: A Systematic Review of Qualitative Studies

Objective:

To synthesize evidence from qualitative studies relating to adolescent girls’ perceptions of physical activity participation. The protocol for this review is registered with PROSPERO (ID no. CRD42017054944).

Data Source:

PubMed, Sports Discus, Academic Search Complete, and Education Resources Information Centre.

Inclusion and Exclusion Criteria:

Studies reporting qualitative data that explored the views/opinions/perceptions of adolescent girls (>12 and <18 years old) published between 2001 and 2016 were included. Studies not in English, those focusing on school physical education or specific sports, and those including special populations were excluded.

Extraction:

Study characteristics and results were extracted to a form developed by the authors and managed using NVivo 10 (QSR International’s NVivo 10 software). Data were extracted by 1 reviewer, and a sample (25%) was checked by a second reviewer.

Synthesis:

Data were synthesized using a thematic network and managed using NVivo 10. The validity of the included studies was assessed using the “Critical Appraisal Skills Programme (2018)” checklist. The ENTREQ and PRISMA statement was followed when reporting this qualitative synthesis.

Results:

Of the 1818 studies identified in the search strategy, 24 met the inclusion criteria and were included in the analysis. Global themes were identified using a thematic network. These themes were “Gender Bias in Sport,” “Motivation and Perceived Competence,” “Competing Priorities during Adolescence,” and “Meeting Societal Expectations.”

Conclusions:

The results of this review provide insights into adolescent girls’ views on physical activity. Future research is needed to investigate the potential impact of alternative activity programs on adolescent girls with appropriate follow-up. Researchers and individuals working with young girls must consider the role of perceived motor competence in participation and how this can impact their perceptions.

Parent, school, and peer factors related to U.S. adolescents' diet and exercise

PURPOSE

Adolescent obesity is a significant public health problem in the United States. Developing interventions to prevent or improve adolescent obesity may positively affect physical and mental health across the lifespan. However, to ensure that interventions are effective, influential factors must first be identified. The purpose of this study was to examine associations among parent-, school-, and peer-related factors and diet and physical activity of the adolescents in the United States.

DESIGN AND METHODS

Using logistic regression analyses, cross-sectional data of 5,248 adolescents in grades 5-10 from 184 schools from the World Health Organization's 2009/2010 survey of Health Behavior in School-Aged Children (HBSC) for the United States were analyzed, including variables for parent, peer, and school factors.

RESULTS

Parent- and peer-related factors were associated with adolescents' diet and physical activity (PA). Peer factors were associated with time spent on PA, but not a parent or school factors. The type of school lunch program was the only school factor associated with diet; no school factors were associated with exercise.

PRACTICE IMPLICATIONS

Results of this secondary analysis extend prior work, which identified associations between parent- and peer factors and adolescents' diet and exercise. Findings will help identify targets for improving adolescents' diet and exercise behaviors.

The Physical Activity Environment and Academic Achievement in Massachusetts Schoolchildren

BACKGROUND

A supportive school-based physical activity environment (PAE) is integral to children's physical activity behaviors, but less understood is its association with academic achievement. We aimed to assess the association between PAE and academic performance and whether a stronger relationship exists in lower-income schools (LIS) compared to middle-income schools (MIS).

METHODS

Schoolchildren (grades 3rd to 5th) were recruited from 17 Massachusetts public schools. Schools were classified based on geographic characteristics and free/reduced-price lunch (FRPL) eligibility (LIS = 7, Median FRPL = 86%; MIS = 10, Median FRPL = 20%). PAE was measured using a 10-item survey. Mixed-effects logistic regression models were used to examine associations between PAE and scoring Advanced/Proficient on standardized Math and English Language Arts (ELA) tests.

RESULTS

Demographic characteristics differed between LIS (N = 278, 5% non-Hispanic white) and MIS (N = 297, 73% non-Hispanic white). In LIS, PAE was associated with Math (odds ratio = 5.40, 95% CI = 2.52-11.54 p < .001), but not ELA test scores (p > .05). There was no relationship between PAE and MIS test scores (p > .05). Schooltime moderate-to-vigorous physical activity was not associated with test scores (p > .05).

CONCLUSIONS

A beneficial relationship exists between a high-PAE and test scores among LIS children, suggesting that the PAE may be associated with a more supportive environment and may be more fundamentally important for lower-income students.

The Influence of Peers on Diet and Exercise Among Adolescents: A Systematic Review

Adolescents' diet and exercise are modifiable factors contributing to high rates of adolescent obesity. Diverse contextual factors, including family, social environment, and peers, affect adolescents' diet and exercise behaviors. Because peer influence increases during adolescence, peers' contributions to adolescents' diet and exercise behaviors should be examined as potential targets for intervention to reduce the prevalence of adolescent obesity. The purpose of this systematic review is to identify research examining the contribution of peers to diet and exercise of adolescents. The electronic databases PubMed, CINAHL, Web of Science, and SCOPUS were searched. A total of 24 unique articles were included: seven examined diet only, fourteen studied exercise only, and three explored diet and exercise. This review provided evidence that diet and exercise of adolescents were significantly associated with those of their peers. However, these associations differed depending on gender, the type of diet and exercise, and closeness of friends. Findings from this review suggest that peers could be possible targets for interventions to promote healthier diet and exercise among adolescents; however, more studies are needed to identify specific peer influences and develop tailored interventions.

Health and nutrition in public and private schools in the city of Recife

Abstract Objectives: to analyze the implementation of initiatives and environments promoting healthy feeding as well as the practice of physical activity in public and private schools in Recife. Methods: the schools selected in the City of Recife (n=39) are part of the sample in the Study of Cardiovascular Risks in Adolescents (ERICA). The degree of implementation was estimated by means of interviews with the school manager emphasizing the following components: community participation, presence of healthy environments, partnership with the health segment, monitoring of nutritional status and nutrition policies. The variables selected were assigned points whose sum rated them as satisfactory implementation, poor implementation and critical implementation. Results: the promotion of healthy eating as well as the practice of physical activity was satisfactorily implemented in 13.8% of public schools. However, no private schools obtained such rating. Public schools, when compared to private schools, showed themselves to be more structured, concerning the policies and environments promoting healthy eating and school community participation, however, they showed greater fragility regarding the promotion of physical activity practice and nutritional status monitoring. A few schools had satisfactory implementation in the partnership with the health segment. Conclusions: public and private schools have presented barriers which compromise the full implementation of initiatives and environments promoting healthy eating and physical activity practice.

Relationship between observational learning and health belief with physical activity among adolescents girl in Isfahan, Iran

Background:

Physical activities among adolescents affects health during pubescence and adolescence and decrease in physical activities among adolescents has become a global challenge. The aim of the present study was to define the relation between the level of physical activity among adolescent girls and their health beliefs as personal factor and level of observational learning as environmental factor.

Materials and Methods:

The present study was a cross-sectional study that was conducted on 400 students aged from 11 to 19 years in Isfahan, Iran. Information regarding the duration of physical activity with moderate/severe intensity was measured in four dimensions of leisure time (exercising and hiking), daily activities, and transportation-related activities using the International Physical Activity questionnaire. Health belief structures included perceived sensitivity, intensity of perceived threat, perceived benefits, and barriers and self-efficacy; observational learning was measured using a researcher-made questionnaire.

Results:

Results showed that perceived barriers, observational learning, and level of self-efficacy were related to the level of physical activity in all dimensions. In addition, the level of physical activity at leisure time, transportation, and total physical activity were dependent on the intensity of perceived threats (P < 0.05).

Conclusions:

This study showed that the intensity of perceived threats, perceived barriers and self-efficacy structures, and observational learning are some of the factors related to physical activity among adolescent girls, and it is possible that by focusing on improving these variables through interventional programs physical activity among adolescent girls can be improved.

Factors affecting school physical education provision in England: a cross-sectional analysis

BACKGROUND

Attitudes towards physical activity are largely developed during childhood meaning that school physical education classes can have a strong influence.

METHODS

National level data of school pupils (n = 21 515) in England were analysed to examine the association between school provision of physical education with sex, age, geographic and socioeconomic factors.

RESULTS

Children attending independent schools had more scheduled physical education time (P < 0.001; 95% confidence interval (CI) 18 to 30 extra min per week). This association was true for males (P = 0.024); schools located in the South (P < 0.001; 95% CI 2 to 3) and rural areas (P < 0.001; 95% CI 3 to 5); or with a higher percentage of pupils eligible for free school meals (P < 0.001; 95% CI 3 to 4). Schools in more affluent areas (P < 0.001; 95% CI -1 to -2) and those with lower percentages of pupils from ethnic minorities (P < 0.001; 95% CI -1 to -2) also had higher minutes of physical education provision per week. Regarding age, 93% of schools met the guidelines in Years 1-9; only 45% did in Years 10-13.

CONCLUSION

Differences in physical education were found in relation to school type, socioeconomic status and geographical factors. Age-related differences in compliance with guidelines are of concern; ways to increase provision for older children should be investigated.

Associations between showering behaviours following physical education, physical activity and fitness in English schoolchildren

We aimed to describe the frequency of showering after physical education (PE) in English high-school pupils. We examined differences in physical activity (PA) and cardiorespiratory fitness according to showering behaviours and examined predictors of showering. We measured PA and cardiorespiratory fitness of n = 3921 pupils (11-16 years, 53.5% males) from eight high schools. Pupils self-reported showering behaviour and parental PA levels. We calculated deprivation and distance travelled to school from their home postcode. Overall, 53% of boys and 68% of girls said they never shower after PE. Pupils who did not shower after PE were less physically active and engaged in fewer team sports. Girls who did not shower also had lower cardiorespiratory fitness than those who did. Showering behaviour varied greatly by school, so we adjusted for clustering at the school level. Pupils were more likely to shower if they were active with their parents [odds ratio (OR) = 1.72; 95% CI: 1.43, 2.07] and less likely to shower if they were from deprived areas (OR = 0.68; 95% CI: 0.52, 0.88). Showering after PE is relatively rare in English schoolchildren, particularly girls. While we cannot infer causality regarding the relationships found here, the low rates of showering and the lower PA and cardiorespiratory fitness (in girls) observed in schoolchildren who do not shower suggest research is needed to determine whether showering is a barrier to being physically active during PE.

Risk behaviors and sports facilities do not explain socioeconomic differences in childhood obesity: a cross-sectional study

Background

To assess whether the relationship between neighborhood socioeconomic context of residence and childhood obesity is explained by family socioeconomic position, risk behaviors and availability of sports facilities.

Methods

Based on the income and educational level of residents in the neighborhoods of the city of Madrid, two indicators of socioeconomic context were calculated using the information about income and education and grouped into quartiles. In a sample of 727 children aged 6–15 years, the relationship of these indicators with overweight and obesity was studied using multilevel logit models.

Results

With respect to children and adolescents living in neighborhoods having higher per capita incomes or higher population percentages with university education those living in neighborhoods having lower per capita incomes or lower population percentages with university education had age- and sex-adjusted odds ratios (ORs) of overweight that were 1.84 (95% CI, 1.03-3.29) and 1.68 (0.95-2.94) times higher, respectively. After adjustment for family socioeconomic position, unhealthy diet and physical inactivity, these ORs fell to 1.80 (0.99-3.29) and 1.56 (0.87-2.79), respectively. In the case of obesity, the age- and sex-adjusted ORs in these quartiles of both indicators of socioeconomic context were 3.35 (1.06-10.60) and 3.29 (1.03-10.52), respectively, rising to 3.77 (1.12-12.70) and 3.42 (1.00-11.68) after adjustment for the remaining variables. The highest OR was observed in the third quartile, except in the case of the relationship between per capita income and obesity. No relationship between the number of sport facilities per 1,000 population and physical inactivity was observed.

Conclusion

The socioeconomic context is associated with obesity but not with overweight children in Madrid. The relationship is not explained by family socioeconomic position, risk behaviors and availability of sports facilities.

Physical activity breaks and facilities in US secondary schools

BACKGROUND

Research on physical activity breaks and facilities (indoor and outdoor) in secondary schools is relatively limited.

METHODS

School administrators and students in nationally representative samples of 8th (middle school) and 10th/12th grade (high school) students were surveyed annually from 2008-2009 to 2011-2012. School administrators reported information about physical activity breaks and facilities. Students self-reported height, weight, and physical activity.

RESULTS

The prevalence of physical activity breaks and indoor and outdoor facilities (dichotomized by median split) differed significantly by region of the country, school size, student race/ethnicity, and school socioeconomic status (SES). Breaks were associated with lower odds of overweight (adjusted odds ratio [AOR] = 0.91, 95% confidence interval [CI]: 0.83-1.00) and obesity (AOR = 0.86, 95% CI: 0.75-0.99) among middle school students. Among low-SES middle school students and schools, higher indoor facilities were associated with lower rates of overweight and obesity. Among high school students, higher indoor and outdoor facilities were associated with 19-42% higher odds of moderate-to-vigorous physical activity.

CONCLUSIONS

Physical activity breaks and school facilities may help to address high rates of overweight/obesity and low physical activity levels among secondary students, especially lower-SES students. Students in all schools should have equal access to these resources.

Socio-environmental influences on physical activity among young people: a qualitative study

This multi-methods qualitative study aimed to identify environmental factors that influence physical activity participation among young people in Edinburgh, Scotland. School pupils (aged 11-13 years) took part using photography, computer blogs, maps and focus group discussions (FGDs). Eleven computer sessions (n = 131) and 14 FGDs (n = 63) took place. Factors influencing physical activity behaviour included proximity and access to local facilities, family and peers and the school physical activity environment. A variety of facilitators and barriers to participation were also reported. Most notable was the importance of cost and value for money when choosing physical activities which, although more evident among pupils attending schools in areas of low socio-economic status (SES), was relevant across all SES groups. Reporting easy access to sports facilities was more common among pupils attending schools from high/medium SES. Use of greenspace for physical activity was reported among pupils from all schools, but was more common among those from low SES schools. Pupils were, in general, satisfied with the facilities available at school, but felt time for physical education could be increased. Findings may help inform interventions, aimed at promoting physical activity at local level.