Social-cognitive correlates of physical activity in a multi-ethnic cohort of middle-school girls: two-year prospective study

A meta-analysis of the relationship between social support and physical activity in adolescents: the mediating role of self-efficacy

Introduction

Social support influences physical activity (PA) in adolescents. However, whether mediating and moderating effects impact the relationship between them or the underlying mechanism remains unclear. This study aimed to investigate the mediating effects of self-efficacy as well as a series of moderating influences using a meta-analytic approach.

Methods

A total of 56 studies published between January 2001 and May 2023 were obtained from the Web of Science, EBSCO, Taylor and Francis, Scopus, Wiley, ProQuest, and CNKI (core) databases, comprising 65 independent samples (total sample size = 47,196).

Results and discussion

The mean weighted correlation coefficients between social, family, peer, and school support and adolescent PA were 0.298, 0.226, 0.256, and 0.142, respectively, which were significant, except for school support. Family support and teenage PA were related, although the connection was moderated by gender and socioeconomic characteristics. While social, family, and peer support had a direct influence on adolescent PA, school support did not. Self-efficacy mediated the relationship between social support and its subtypes and adolescent PA.

Organized Physical Activity Program Participation, Physical Activity, and Related Psychosocial Factors Among Urban Adolescents

The study purpose was to examine whether adolescents who participated in organized physical activity (PA) programs differed from nonparticipants in motivation, social support, and self-efficacy related to PA; PA (min/hr); and sedentary screen time behavior. Thirty-nine 5th-7th grade adolescents participated in organized PA programs; 41 did not. Approximately 56.3% were Black, and 52.5% had annual family incomes <$20,000. Compared to nonparticipants, those who participated reported significantly higher social support (M = 2.32 vs. 3.13, p < .001) and fewer hours watching television or movies on a usual weekend day (M = 2.49 vs. 1.59, p = .016); and had higher accelerometer-measured vigorous PA (M = 0.58 vs. 1.04, p = .009) and moderate-to-vigorous PA (M = 2.48 vs. 3.45, p = .035). Involving adolescents in organized PA programs may be important for improving their moderate-to-vigorous PA, vigorous PA, and related psychosocial factors, as well as reducing sedentary screen time behavior.

Enhancing the Content Validity of Self-Reported Physical Activity Self-Efficacy in Adolescents: A Qualitative Study

PURPOSE

This study's primary purpose was to enhance the content validity of a self-reported measure of self-efficacy for physical activity (PA) in adolescents. This was addressed through assessment of younger and older adolescents' understanding of the construct of self-efficacy for PA, coupled with assessment of the content coverage and comprehensibility of items derived from existing measures.

METHODS

Participants completed individual semistructured and cognitive debriefing interviews as well as 3 PA self-efficacy questionnaires.

RESULTS

Thematic analysis identified personal and environmental facilitators and barriers to PA self-efficacy. The major categories were physical; psychological; interaction with surroundings; support and relationships; attitudes; and services, systems, and natural environments. Cognitive interviews resulted in the retention of 52 final items: 24 for self-efficacy with perceived facilitators and 28 for self-efficacy to overcome barriers.

CONCLUSIONS

This study provides a PA self-efficacy instrument with expanded content coverage that is relevant to adolescents as young as 11 years. With further validation testing in future studies, this instrument will enable pediatric physical therapists and researchers to assess PA self-efficacy and design effective intervention strategies to improve PA.

The Effects of a Multicomponent Social Support Intervention on Physical Fitness and Exercise Attitude in Children: A 12-Week Randomized Controlled Trial

Purpose: The current study is intended to assess the effects of a multicomponent social support intervention program on grip strength, sprinting, jumping, agility, flexibility, core strength and exercise attitude among children over a period of twelve weeks. Method: This study followed a randomized parallel design in which 366 children (age: 9.35 ± 1.12 years) in the 3rd−5th grade at an elementary school in China were allocated to an intervention group (n = 183) or a control group (n = 183). Participants were assessed twice (baseline and postintervention) for the following tests: (i) grip strength, (ii) 50 m dash, (iii) rope skipping, (iv) sit-ups, (v) sit-and-reach, and (vi) exercise attitude. The intervention group received the “Exercise Methods and Wellness Knowledge Guide (EMWKG)” leaflet three times a week. The control group was not required to make any changes. Results: Significant increases in pre−post left-hand grip strength (Cohen’s d = 0.10, p < 0.001), right-hand grip strength (Cohen’s d = 0.09, p < 0.001), and behavioral intention (Cohen’s d = 0.17, p < 0.01) were observed in the intervention group. Students in the control group showed significant decreases in three indicators: both 50 m (Cohen’s d = 0.19, p < 0.01) and sit-ups (Cohen’s d = 0.14, p < 0.05) as well as sit-and-reach (Cohen’s d = 0.46, p < 0.001). Significant differences (p < 0.001) were found between the two groups in right-hand grip strength (F = 7.109, ηp2 = 0.020), sit-and-reach (F = 11.255, ηp2 = 0.031), and subjective standards (F = 15.461, ηp2 = 0.043). A comparison of the post hoc test results showed that the intervention group scored 0.519 kg (95% CI: 0.136−0.901, Cohen’s d = 0.27), 0.944 cm (95% CI: 0.0391−1.497, Cohen’s d = 0.35), and 2.535 points (95% CI: 1.267−3.803, Cohen’s d = 0.41) higher than the control group in right-hand grip strength, sit-and-reach, and subjective standards, respectively. Conclusion: This combined social support theory-based intervention was effective in improving exercise attitude and fitness among children in 12 weeks.

Longitudinal association of biological maturation with physical activity behaviors in girls transitioning from 5th to 7th grade

Introduction

This longitudinal study determined if social cognitive variables influence physical activity in girls stratified on the basis of maturity status.

Methods

Participants attended South Carolina public schools (Mage in 5th grade = 11.1 years) and included a cohort of 529 girls who provided physical activity data in the 5th grade and in 6th and/or 7th grade. The measure of maturity status was age at peak height velocity (APHV) estimated from maturity offset when the children were in the 5th grade. The Earlier Maturity (EM) group included girls whose APHV was one standard deviation or more below the mean APHV for the full sample. All other girls were placed in the Later Maturity (LM) group. Physical activity was assessed at each time point via accelerometry. Social‐cognitive variables were assessed at each time point by a questionnaire measuring self‐efficacy, enjoyment, competence, appearance, fitness, and social motives for physical activity. Growth curves for the total, Earlier Maturing, and Later Maturing groups assessed relationships between physical activity over time and time‐varying social cognitive variables.

Results

Physical activity was lower in the Earlier Maturing group and was positively associated with self‐efficacy and enjoyment motivation in the total group. These relationships were observed in the 5th grade and maintained through 7th grade. In the Later Maturing group, we observed positive relationships between physical activity and self‐efficacy, enjoyment and competence motivation.

Conclusions

Strategies to increase confidence, skills, and enjoyment of physical activity may only be effective for promoting activity among later maturing girls.

Physical Activity Habits and Well-Being among 6-Year-Old Children: The "Improving Umbrian Kids' Healthy Lifestyle", an Uncontrolled Pilot Study Project

There is evidence that promoting physical activity programs and decreasing sedentary behavior is a potential strategy for improving health-outcomes, peer relationships and social/emotional well-being in at-risk youth. The World Health Organization recommends enhancing physical education and school-based programs with multi-component and evidence-based assessment methodology. In Umbria (Italy) an uncontrolled pilot study project referred to as "Improving Umbrian kids' healthy lifestyle" was implemented as a systemic school-based intervention directed at 6-year-old primary school children. The intervention applied a consolidated assessment methodology developed by the C.U.R.I.A.Mo. and Eurobis projects that inserted two hours per week of physical education activity into the school curriculum, structured and supervised by specialists with Exercise and Sport Science degrees, for eight months (from October to June) of the school year. We measured anthropometric values (BMI, waist circumference, waist-to-height ratio index) with objective tools. Moreover, we evaluated physical performance variables (speed, strength, and flexibility) using standard tests. Additionally, self-report measures (measured physical activity during the week, sedentary habits, and psychological well-being) were assessed using validated questionnaires. We observed a significant decrease in waist to height ratio, and improvements in physical performance values and self-report questionnaire measures. Our study suggests that the promotion of physical activity in the school setting is likely to result in physically, mentally, and psycho-socially healthier primary-school-age children.

The Relationship Between Self-Regulatory Efficacy and Physical Activity in Adolescents With a Caveat: A Cross-Lag Design Examining Weather

PURPOSE

The use of self-efficacy to predict physical activity has a long history. However, this relationship is complex, as self-efficacy is thought to influence and be influenced by physical activity. The directionality of the self-regulatory efficacy (SRE) and physical activity relationship was examined using a cross-lagged design. A secondary purpose was to examine these relationships across differing weather conditions.

METHODS

Canadian adolescents (N = 337; aged between 13 and 18 years) completed the physical activity and SRE measures 4 times during a school year. Structural equation modeling was used to perform a cross-lag analysis.

RESULTS

The relationships between physical activity and SRE appeared to be weather dependent. During a more challenging weather period (eg, cold weather), the relationship between physical activity and SRE was bidirectional. However, no relationship emerged when the 2 constructs were assessed during a more optimal weather period (eg, warm weather).

CONCLUSIONS

Some support has been provided for the bidirectional nature of the relationship between physical activity and SRE. The relationship appeared to be qualified by climate considerations, suggesting that future research examine how weather may relate not just to physical activity but also to the correlates of physical activity.

Exercise interventions for mental disorders in young people: a scoping review

AIMS

This scoping review determines the breadth and outcomes of controlled trials testing the effect of physical activity/exercise interventions across mental health outcomes in young people with a mental disorder.

METHODS

The literature search was conducted using the open-access 'Evidence Finder', a comprehensive youth mental health-specific database that is systematically populated from MEDLINE, Embase, PsycINFO and Cochrane CENTRAL databases.

RESULTS

Sixteen publications were identified after meeting the following eligibility criteria: (1) participants were young people (mean age 12-25.9 years) with a mental disorder diagnosed by a trained clinician or by reaching a predefined cut score on a symptom measure, (2) interventions were exercise, (3) designs were randomised or non-randomised controlled trials, (4) outcomes were mental health related. Eight studies included young people with depression, three included people with psychosis/schizophrenia, three included people with eating disorders and two included people with anxiety. The available evidence suggests that moderate-to-vigorous-intensity exercise may be beneficial, particularly for reducing depression. The available evidence for other intervention intensities, and for other mental disorders, is mixed.

CONCLUSIONS

Overall, the evidence regarding the impact of exercise interventions on a range of mental health outcomes in clinical populations of young people with various mental disorders looks promising but requires further development. Findings from this scoping review can inform the development of future exercise interventions in the youth mental health field.

Mediators of Physical Activity Behavior Change in the "Girls on the Move" Intervention

BACKGROUND

The minimal effect of interventions to date on increasing young adolescent girls' physical activity (PA) may be due to inadequate understanding of the mechanisms underlying behavior change, yet sparse research testing a PA intervention has examined the capacity of theories to explain PA, particularly when using objective measures.

OBJECTIVES

The aim of the study was to examine whether constructs from the health promotion model and self-determination theory mediated changes in moderate-to-vigorous physical activity (MVPA) following a 17-week intervention.

METHODS

The study was a secondary analysis of data from a group randomized trial, including 12 intervention and 12 control schools in the Midwestern United States. Data were collected in 2012-2016. Girls (fifth- to eighth-grade, N = 1,519) completed surveys on perceived benefits and enjoyment of PA, PA self-efficacy, social support and motivation for PA, and barriers to PA and wore accelerometers.

RESULTS

The final path model had a good fit: χ(4) = 2.48, p = .648; goodness-of-fit index = 1; comparative fit index = 1; root-mean-square error of approximation = 0; standardized root-mean-square residual = 0.01. For MVPA change from baseline to postintervention, enjoyment (B = 24.48, p < .001) and social support (B = 30.48, p < .001) had a positive direct effect, whereas the intervention had a positive indirect effect through enjoyment and social support (B = 9.13, p < .001). Enjoyment (B = -13.83, p < .001) and social support (B = -17.22, p < .001) had a negative indirect effect on MVPA change from postintervention to follow-up.

DISCUSSION

Enjoyment of PA and social support for PA may be important mediators of PA in young adolescent girls and warrant consideration when designing interventions.

Healthy for Life Pilot Study: A Multicomponent School and Home Based Physical Activity Intervention for Disadvantaged Children

The study aimed to develop and evaluate a multicomponent school and home based physical activity (PA) intervention in children in grades 3–7 (aged 8–13 years) and determine the psychological variables that influence PA; 10 × 1 h school-based training sessions, a home-based activity program and 4 × 1 h lifestyle workshops for parents. PA was assessed at an intervention and nearby control school using accelerometers and self-report at 3-time points: baseline, post intervention and 10-week follow-up. Self-efficacy, self-management strategies, enjoyment, perceived barriers to PA, outcome-expectancy and social support were evaluated. The study showed 73% of the children with complete data sets at the intervention school (n = 27) did not increase device measured moderate to vigorous PA (MVPA) in the after-school period (3 p.m. to 6 p.m.) or over the whole day or during school break time immediately following the intervention or at follow-up, as compared to 70% of children with complete data sets at the control school (n = 35; p > 0.05 for all). Overall, 59% of boys attained more than double the recommended 120 min of MVPA each day compared to 42% of girls (p = 0.013). At the baseline, children’s self-reported PA in the intervention school positively correlated with: outcome expectancy (R = 0.240, p = 0.015), enjoyment (R = 0.339, p < 0.001), self-efficacy (R = 0.399, p < 0.001), self-management (R = 0.617, p < 0.001), social support at home (R = 0.406, p < 0.001), and social support at school (R = 0.407, p < 0.001). Similar relationships were observed after the intervention and at follow-up. Focus groups with the children, parents and interviews with teachers identified areas for improvement of the intervention. In conclusion, while the multifaceted approach to improve PA was ineffective over the time span of the study, important predictors of PA in this sample of disadvantaged children were identified.

Aggie Play: A Gender-Relevant Physical Activity Program for Girls

A majority of U.S. children age 6-17 years do not meet the recommended 60 min of moderate to vigorous physical activity per day. Girls are less likely to meet these daily physical activity guidelines than boys. Following a call for greater gender-relevant physical activity programming, Aggie Play, an after-school physical activity program, engaged female student athletes to serve as active role models who lead girls through high-energy activities twice a week over a school year. The purpose of this study was to explore how Aggie Play affected girls' self-efficacy and expected enjoyment for physical activity, time spent in various physical activity intensities during free play, and fitness, relative to a control group. Results revealed that the girls participating in Aggie Play increased ratings of physical activity self-efficacy and enjoyment compared with girls at a control site. Aggie Play girls also demonstrated greater improvements on the muscle-endurance test than girls at a control site. Results are consistent with prior gender-relevant physical activity and physical education research. This study extends prior results by documenting the benefits of gender-relevant physical activity programming when led by active female role models.

Predicting physical activity among urban adolescent girls: A test of the health promotion model

The purpose of this study was to test hypothesized relationships of the health promotion model (HPM) as a means of predicting moderate-to-vigorous physical activity (MVPA) among urban, adolescent girls. A secondary analysis of baseline data from a group randomized controlled trial was conducted. The study involved eight urban schools in the Midwestern United States. The sample included girls (N = 517) in the 5th-8th grades. Data were collected on age, body mass index, pubertal status, enjoyment, self-efficacy, social support, options for physical activity (PA), and commitment to PA. MVPA was measured via accelerometers worn by the girls for 7 days. Structural equation modeling was used to analyze study aims. Mean age of the sample was 11.8 years (standard deviation [SD] = 1.0). Girls attained an average of 3.0 (SD = 1.2) minutes per hour of MVPA. Self-efficacy had a positive direct (β = .337; p < .001) and total effect (β = .310; p < .001) on MVPA. Social support and options for PA were not significant predictors of commitment to PA or MVPA. Commitment to PA had a negative but nonsignificant effect (β = -.056; p = .357) on MVPA. The model predicted 10.1% of the variance in MVPA with 9.6% of the variance predicted by self-efficacy. Limitations include lack of longitudinal analysis and inability to generalize the results to other populations such as boys. PA self-efficacy continues to emerge as a significant predictor of MVPA in the HPM. Continued theory testing is needed to better understand the correlates and determinants of PA among adolescent girls before designing theory-based interventions to promote PA.

Self-efficacy, beliefs, and goals: Moderation of declining physical activity during adolescence

OBJECTIVE

To examine whether the decline in physical activity observed from childhood through adolescence is explained by moderating effects of self-efficacy on concurrent changes in children's goals and beliefs about their physical activity environments.

METHOD

Latent growth modeling was used in longitudinal tests in a cohort of 79 boys and 108 girls assessed in 5th, 6th, 7th, 9th, and 11th grades.

RESULTS

Physical activity measured objectively by an accelerometer declined most in students who had bigger declines in self-efficacy and (1) maintained higher perceptions of barriers to physical activity, (2) had bigger declines in enjoyment and fitness goals, or (3) had smaller declines in appearance and social goals.

CONCLUSIONS

Trials of physical activity interventions based on social-cognitive theory should consider that the influence of changing goals on physical activity may differ according to whether students maintain high efficacy beliefs about overcoming barriers to physical activity coincident with perceptions of their physical activity environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Change in Children's Physical Activity: Predictors in the Transition From Elementary to Middle School

INTRODUCTION

Interventions to promote physical activity in children should be informed by knowledge of the factors that influence physical activity behavior during critical developmental transitions. The purpose of this study is to identify, from a comprehensive, multidomain set of factors, those that are associated with change in objectively measured physical activity in children as they transition from elementary to middle school.

METHODS

The study used a prospective cohort design, with children observed in fifth, sixth, and seventh grades. Growth curve analyses were used to examine associations between exposure variables measured at baseline and children's physical activity across three observations. A total of 828 children, aged 10.6 (SD=0.5) years at baseline provided physical activity data in fifth grade and at one or both follow-ups. Exposure variables assessed child characteristics, parent characteristics, home characteristics, social factors, school environment, and community characteristics. Physical activity was measured via accelerometry. Data were collected in two school districts in South Carolina in 2010-2013 and analyzed in 2017.

RESULTS

Variables measured within the child, parent/home, and community domains were positively associated with children's physical activity as they transitioned from fifth to seventh grade. These included parent encouragement of physical activity, parental support for physical activity, child sports participation, parent's report of the child's physical activity level, the child's time spent outdoors, social spaces for physical activity in the community, and the number of physical activity facilities that were proximal to the child's home.

CONCLUSIONS

Interventions designed to increase children's physical activity should include strategies that target multiple domains of influence.

Go with the FLOW: Implementation of a psychological skills intervention in an exercise program for post-bariatric surgery patients

Bariatric surgery is an effective obesity treatment; however, most individuals regain weight following surgery. Following a Lifestyle of Wellness (FLOW) is a psychological skills intervention with strategies designed to increase self-efficacy and promote living a healthy lifestyle including regular physical activity. Eleven participants completed FLOW. Results indicated participants enjoyed the program and intended to continue this lifestyle upon program completion. Interviews indicated FLOW was effective for improving self-perceptions, and exercise motivation. The most effective sessions were goal setting, future planning, and stress management. Suggestions for program improvement were provided. This information can be used to improve the FLOW program and for implementation into other settings.

A School- and Home-Based Intervention to Improve Adolescents' Physical Activity and Healthy Eating: A Pilot Study

This study evaluated feasibility, acceptability, and preliminary efficacy of a 12-week Guys/Girls Opt for Activities for Life (GOAL) intervention on 10- to 13-year-old adolescents' body mass index (BMI), percent body fat, physical activity (PA), diet quality, and psychosocial perceptions related to PA and healthy eating. Parent-adolescent dyads from two schools were enrolled. Schools were assigned to either GOAL (38 dyads) or control (43 dyads) condition. The intervention included an after-school club for adolescents 2 days/week, parent-adolescent dyad meeting, and parent Facebook group. Intervention adolescents had greater autonomous motivation for PA and self-efficacy for healthy eating than control adolescents (both p < .05). Although between-group differences were not significant, close-to-moderate effect sizes resulted for accelerometer-measured moderate-to-vigorous PA and diet quality measured via 24-hr dietary recall (d = .46 and .44, respectively). A trivial effect size occurred for percent body fat (d = -.10). No differences emerged for BMI. Efficacy testing with a larger sample may be warranted.

Developmental Trends and Determinants of Physical Activity From Adolescence to Adulthood Differ by Ethnicity/Race and Sex

BACKGROUND

Interventions to raise population physical activity generally show modest effects; one possible reason is that trends and determinants of moderate to vigorous physical activity (MVPA) differ between population subgroups. This study examined differences in trends and determinants of reported MVPA by ethnicity/race and sex in a 15-year longitudinal study.

METHODS

Participants (n = 2092) in the Project Eating and Activity in Teens and Young Adults study were surveyed on MVPA behavior and potential determinants from adolescence to young adulthood. Generalized estimating equations were used to model age trends in MVPA and associations with determinants.

RESULTS

Mean MVPA declined by 2.1 hours per week over 15 years of follow-up from adolescence to young adulthood. Asian males reported the lowest levels of MVPA at each age. Nonwhite females reported less MVPA than white females at each age. The association of body mass index (BMI) with MVPA differed by sex and ethnicity/race. Asian males and females showed lower levels of MVPA at both low and high BMI.

CONCLUSIONS

Interventions to increase MVPA may need to begin earlier among Asian men and nonwhite women than among other groups. Asian adolescents with lower BMI show lower MVPA and may benefit from additional intervention efforts compared with Asian adolescents with normal BMI.

Naturally-occurring changes in social-cognitive factors modify change in physical activity during early adolescence

PURPOSE

To determine whether naturally-occurring changes in children's motives and beliefs are associated with the steep decline in physical activity observed from childhood to early adolescence.

METHODS

Latent growth modeling was applied in longitudinal tests of social-cognitive influences, and their interactions, on physical activity in a large cohort of boys and girls evaluated annually between 5th and 7th grades.

RESULTS

Measurement equivalence of motives and beliefs was confirmed between boys and girls. After adjustment for gender and maturity differences, physical activity declined less in children who reported the least decreases in self-efficacy for overcoming barriers to activity and perceived parental support. Physical activity also declined less in students who persistently felt they had more parental and friend support for activity compared to those who reported the largest decrease in support from friends. After further adjustment for race, the decline in physical activity was less in those who had the largest decrease in perceived barriers and maintained a favorable perception of their neighborhood environment. Changes in enjoyment and social motives were unrelated to change in physical activity.

CONCLUSION

Using an objective measure of physical activity, we confirm that naturally-occurring changes in children's beliefs about barriers to physical activity and their ability to overcome them, as well as perceptions of their neighborhood environment and social support, are concurrent with age-related declines in children's physical activity. The longitudinal findings confirm these putative social-cognitive mediators as plausible, interacting targets of interventions designed to mitigate the marked decline in physical activity that occurs during the transition between elementary and middle schools.

Psychometric Evaluation of Three Psychosocial Measures Associated With Physical Activity Among Adolescent Girls

The purpose of this study was to evaluate the psychometric properties of a Perceived Benefits Scale, a Perceived Barriers Scale, and a Physical Activity Enjoyment Scale with data from a group randomized controlled trial (RCT) and a test-retest study with 1-week interval. In the group RCT at baseline and Week 17, 1,012 fifth- to eighth-grade girls completed an iPad-delivered survey and wore 7-day accelerometers measuring moderate-to-vigorous physical activity (MVPA). In the test-retest study, 91 fifth- to seventh-grade girls completed the iPad-delivered survey at Times 1 and 2. Benefits, barriers, and enjoyment scales had Cronbach's αs of .75, .86, and .78 and test-retest reliability of .83, .88, and .79, respectively. Benefits Scale had a two-factor structure (physical and psychosocial benefits), while the remaining two had a one-factor structure indicating construct validity. Barriers ( r = -.16) and enjoyment ( r = .17) were correlated with MVPA indicating concurrent validity. Baseline MVPA and psychosocial benefits positively, while physical benefits negatively, predicted MVPA at Week 17 indicating predictive validity. The measures demonstrated satisfactory psychometric properties.

Development of a dynamic computational model of social cognitive theory

Social cognitive theory (SCT) is among the most influential theories of behavior change and has been used as the conceptual basis of health behavior interventions for smoking cessation, weight management, and other health behaviors. SCT and other behavior theories were developed primarily to explain differences between individuals, but explanatory theories of within-person behavioral variability are increasingly needed as new technologies allow for intensive longitudinal measures and interventions adapted from these inputs. These within-person explanatory theoretical applications can be modeled as dynamical systems. SCT constructs, such as reciprocal determinism, are inherently dynamical in nature, but SCT has not been modeled as a dynamical system. This paper describes the development of a dynamical system model of SCT using fluid analogies and control systems principles drawn from engineering. Simulations of this model were performed to assess if the model performed as predicted based on theory and empirical studies of SCT. This initial model generates precise and testable quantitative predictions for future intensive longitudinal research. Dynamic modeling approaches provide a rigorous method for advancing health behavior theory development and refinement and for guiding the development of more potent and efficient interventions.

Adolescents' Perception of the Psychosocial Factors affecting Sustained Engagement in Sports and Physical Activity

The purpose of this study was to explore adolescents' perceptions of psychosocial influences - personal characteristics, environmental factors and behavioural undertakings - influencing their prolonged involvement in sports and physical activity (PA). A qualitative approach was adopted wherein 16 adolescents (8 boys, 8 girls; mean age 15.9 years), who had been physically active for at least the last 8 years, and sixteen adults identified as their 'parents' or 'guardians' participated in semi-structured interviews. Interviews were transcribed verbatim and coded using the HyperRESEARCH software. Data were analysed using thematic analysis procedures. Four main themes pertaining to psychosocial influences were identified: 1) personal characteristics; 2) school and community resources; 3) parental support; and 4) social interaction. Except for social interaction, for which participants did not identify challenges, themes are discussed according to their motivational aspects and the challenges they represent for adolescents' PA involvement. The research has implications for health promotion endeavours directed toward parents of children and adolescents. Given the limitations of a qualitative study, readers are invited to apply the conclusions to their own context.

The role of social support on physical activity behaviour in adolescent girls: a systematic review and meta-analysis

Abstract

Adolescent girls have been targeted as a priority group for promoting physical activity levels however it is unclear how this can be achieved. There is some evidence to suggest that social support could impact the physical activity levels of adolescent girls, although the relationship is complex and not well understood. We aimed to systematically review and meta-analyse the relationship between social support and physical activity in adolescent girls, exploring how different types and providers of social support might influence the relationship. Articles were identified through a systematic search of the literature using 14 electronic databases, personal resources, grey literature, and reference lists of included studies and previous reviews. Search terms representing social support, physical activity and adolescent girls were identified and used in various combinations to form a search strategy which was adapted for different databases. Cross-sectional or longitudinal articles published in English that reported an association between social support and physical activity in adolescent girls between the ages of 10 to 19 years were included. Studies that focused only on clinical or overweight populations were excluded. Data extraction was carried out by one reviewer using an electronic extraction form. A random 25 % of included articles were selected for data extraction by a second reviewer to check fidelity. Risk of bias was assessed using a custom tool informed by the Critical Appraisal Skills Programme Cohort Study Checklist in conjunction with data extraction. Cross-sectional results were meta-analysed and longitudinal results were presented narratively. Small but significant associations between all available providers of total social support (except teachers) and physical activity were found (r = .14-.24). Small but significant associations were also identified for emotional, instrumental and modelling support for some providers of support (r = .10-.21). Longitudinal research supported the cross-sectional analyses. Many of the meta-analysis results suggested high heterogeneity and there was some evidence of publication bias, therefore, the meta-analysis results should be interpreted with caution. In conclusion, the meta-analysis results suggest that social support is not a strong predictor of physical activity in adolescent girls though parents and friends may have a role in enhancing PA.

Trial registration

PROSPERO 2014:CRD42014006738

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-016-0405-7) contains supplementary material, which is available to authorized users.

Mediating Effects of Self-Efficacy, Benefits and Barriers on the Association between Peer and Parental Factors and Physical Activity among Adolescent Girls with a Lower Educational Level

Background

The prevalence of physical activity among lower educated adolescent girls is low, suggesting it is important to have insights into the complex processes that may underlie their physical activity levels. Therefore, this study aimed to examine the mediating effects of self-efficacy, perceived benefits and barriers on the associations between peer and parental variables and physical activity among lower educated adolescent girls.

Methods

In total, 226 girls (mean age 16.0±1.0 years; 53% technical education; 47% vocational education) from a convenience sample of 6 secondary schools in Flanders, Belgium, completed a questionnaire on their total physical activity level and related peer and parental variables (i.e. modeling of physical activity, co-participation in physical activities and encouragement to be active) and personal variables (i.e. self-efficacy to be active, and specific perceived benefits of physical activity and specific barriers to be active). Mediating effects were tested using MacKinnon’s product-of-coefficients test based on multilevel linear regression analyses.

Results

Higher peer and parental modeling, co-participation and encouragement were significantly related to a higher physical activity level among adolescent girls (p<0.05). Self-efficacy, the perceived benefits of having fun, being around friends or meeting new people, and not being bored and the perceived barrier of not liking physical activity mediated several associations between peer and parental variables and girls’ physical activity, with some of the mediated proportions exceeding 60%.

Conclusions

This study contributed to a better understanding of the complexity of how parental and peer factors work together with personal factors to influence the physical activity levels of adolescent girls with a lower educational level. Interventions should involve both peers and parents, as they may influence girls’ physical activity both directly and indirectly through the internalisation of several personal variables, such as self-efficacy to be active and the perceived benefit of having fun.

Classes of Physical Activity and Sedentary Behavior in 5th Grade Children

OBJECTIVES

We identified classes of physical activity (PA) and sedentary behaviors (SB) in 5th grade children, associated factors, and trajectories of change into 7th grade.

METHODS

This study included N = 495 children (221 boys, 274 girls) who participated in the Transitions and Activity Changes in Kids (TRACK) Study. PA was assessed objectively as well as by self-report. Children, parents, and school administrators completed surveys to assess related factors. Latent class analysis, growth modeling, and adjusted multinomial logistic regression procedures were used to classify children based on self-reported PA and SB and examine associated factors.

RESULTS

Three classes of behavior were identified: Class 1: Low PA/Low SB; Class 2: Moderate PA/ High SB; and Class 3: High PA/High SB (boys) or Class 3: High PA (girls). Class 3 children had higher levels of self-efficacy (boys), and enjoyment, parental support, and physical activity equipment at home (girls). Class 2 boys and Class 3 girls did not experience decline in PA (accelerometer) over time.

CONCLUSIONS

Self-efficacy (boys) and home environment (girls) may play a role in shaping patterns of PA in children. Findings may help to inform future interventions to encourage children to meet national PA guidelines.

Physical Activity, Affect, and Cognition in Children With Symptoms of ADHD

OBJECTIVE

To examine the role of physical activity in determining the affect and executive functioning of children with symptoms of ADHD.

METHOD

In Study 1, the association between physical activity and affect in the daily lives of children with varying degrees of hyperactivity was examined. In Study 2, children with ADHD were randomly assigned a physical activity or a sedentary task before working on a task requiring executive control.

RESULTS

Lack of physical activity was shown to relate to depressed affect, more strongly in participants with severe hyperactivity symptoms (Study 1). The physically active participants showed improved executive functioning after only 5 min of vigorous activity; the sedentary control participants showed no improvement (Study 2).

CONCLUSION

These results indicate that interventions to increase the level of physical activity in children with and without ADHD might improve affect and executive functioning.

Reliability and Validity of the Commitment to Physical Activity Scale for Adolescents

PURPOSE

To examine psychometric properties of a Commitment to Physical Activity Scale for Adolescents (CPASA).

DESIGN

Two test-retest studies and a prospective study, approved by a university institutional review board, were conducted in midwestern U.S. urban areas.

SETTING

The first test-retest study occurred in four community centers, the second test-retest study took place in a community school, and the prospective study occurred in eight middle schools.

SUBJECTS

To measure commitment at baseline and 1 week later, 51 girls in the first test-retest study completed an original 26-item scale, and 91 in the second test-retest study completed a revised 11-item scale. In the prospective study, 503 girls completed the 11-item scale.

MEASURES

Commitment was measured via the CPASA. After completing the CPASA, girls in the prospective study wore ActiGraph GT3X-plus accelerometers that measured light, moderate, and vigorous physical activity (LMVPA) and moderate to vigorous physical activity (MVPA).

ANALYSIS

Internal consistency and test-retest reliability were estimated. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to cross-validate the factor structure.

RESULTS

For the 11-item CPASA, Cronbach α ranged from .81 to .82, and test-retest reliability was .88. Both EFA and CFA indicated a single factor. The scale was significantly correlated with LMVPA (r = .10) and MVPA (r = .11).

CONCLUSION

The 11-item CPASA demonstrated acceptable reliability and validity with girls.

Biological and Sociocultural Differences in Perceived Barriers to Physical Activity Among Fifth- to Seventh-Grade Urban Girls

BACKGROUND

Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined.

OBJECTIVES

The threefold purpose of this study was to (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index, recreational screen time, sedentary activity, and PA; and (c) identify girls' top-rated perceived barriers to PA.

METHODS

Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous PA (MVPA), and light plus MVPA.

RESULTS

Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p < .001). Girls' perceived barriers were negatively related to MVPA (r = -.10, p = .03) and light plus MVPA (r = -.11, p = .02). Girls' top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain.

DISCUSSION

Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA.

Adolescents' preferences for social support for healthful eating and physical activity

OBJECTIVE

This study explored adolescents' views on the sources and types of social support they would prefer when trying to eat more healthfully and be more active, as well as their opinions regarding means of enhancing social support in interventions.

METHODS

A total of 28 adolescents (14 males, 14 females) ages 13 to 18 years participated in 4 focus groups that were stratified by gender and age to enhance participation.

RESULTS

As expected, participants most readily named parents and friends as important sources of support and described wanting instrumental and emotional support from parents, companionship and emotional support from friends, and informational support from professionals. The focus groups revealed rich information regarding parents' and peers' behaviors that are and are not received as emotionally supportive, the helpfulness of parents' concurrent changes in lifestyle, and the importance of parents not ignoring or colluding with unhealthful behavior. Most participants expressed a need for frequent contact and a trusting relationship with professionals. Opinions were mixed regarding inclusion of others in appointments, use of electronic communications and social media, and group treatment formats.

CONCLUSION

Results have implications for enhancing social support in behavioral weight management interventions that are developmentally relevant for adolescents.

Physical activity and social support in adolescents: a systematic review

The objective of this review was to systematically synthesize the results of original studies on the association between physical activity and social support in adolescents, published until April 2011. Searches were carried out in Adolec, Eric, Lilacs, Medline, SciELO, Scopus, SportsDiscus and Web of Science electronic databases and the reference lists of selected articles. Searches for articles, data extraction and assessment of methodological quality were conducted independently by two reviewers. In total, 75 articles met inclusion criteria and were analyzed. Most studies were published over the past 6 years (2006-11), conducted in high-income countries, with a cross-sectional design, using subjective measures of physical activity (e.g. questionnaires and recall) and exhibited medium to high methodological quality level. Social support was positive and consistently associated with the physical activity level of adolescents in cross-sectional and longitudinal studies. Those who received more overall social support as well as support from both parents, friends and family showed higher levels of physical activity. It is concluded that social support is an important factor associated with physical activity level in adolescents and should be targeted in intervention programs that aim to increase physical activity levels in this population group.

Exploring associations between parental and peer variables, personal variables and physical activity among adolescents: a mediation analysis

BACKGROUND

This study aimed to investigate how parental and peer variables are associated with moderate- to-vigorous intensity physical activity (MVPA) on week- and weekend days among Australian adolescents (13-15 y), and whether perceived internal barriers (e.g. lack of time), external barriers (e.g. lack of others to be physically active with) and self-efficacy mediated these associations.

METHODS

Cross-sectional data were drawn from the Health, Eating and Play Study, conducted in Melbourne, Australia. Adolescents (mean age = 14.11 ± 0.59 years, 51% girls) and one of their parents completed a questionnaire and adolescents wore an ActiGraph accelerometer for a week (n = 134). Mediating effects of perceived barriers and self-efficacy were tested using MacKinnon's product-of-coefficients test based on multilevel linear regression analyses.

RESULTS

Parental logistic support was positively related to MVPA on weekdays (τ = 0.035) and weekend days (τ = 0.078), peer interest (τ =0.036) was positively related to MVPA on weekdays, and parental control (τ = -0.056) and parental concern (τ = -0.180) were inversely related to MVPA on weekdays. Internal barriers significantly mediated the association between parental logistic support and MVPA on weekdays (42.9% proportion mediated). Self-efficacy and external barriers did not mediate any association.

CONCLUSIONS

Interventions aiming to increase adolescents' MVPA should involve parents, as parental support may influence MVPA on weekdays by reducing adolescents' perceived internal barriers. Longitudinal and experimental research is needed to confirm these findings and to investigate other personal mediators.

Increasing specificity of correlate research: exploring correlates of children's lunchtime and after-school physical activity

Background

The lunchtime and after-school contexts are critical windows in a school day for children to be physically active. While numerous studies have investigated correlates of children’s habitual physical activity, few have explored correlates of physical activity occurring at lunchtime and after-school from a social-ecological perspective. Exploring correlates that influence physical activity occurring in specific contexts can potentially improve the prediction and understanding of physical activity. Using a context-specific approach, this study investigated correlates of children’s lunchtime and after-school physical activity.

Methods

Cross-sectional data were collected from 423 South Australian children aged 10.0–13.9 years (200 boys; 223 girls) attending 10 different schools. Lunchtime and after-school physical activity was assessed using accelerometers. Correlates were assessed using purposely developed context-specific questionnaires. Correlated Component Regression analysis was conducted to derive correlates of context-specific physical activity and determine the variance explained by prediction equations.

Results

The model of boys’ lunchtime physical activity contained 6 correlates and explained 25% of the variance. For girls, the model explained 17% variance from 9 correlates. Enjoyment of walking during lunchtime was the strongest correlate for both boys and girls. Boys’ and girls’ after-school physical activity models explained 20% variance from 14 correlates and 7% variance from the single item correlate, “I do an organised sport or activity after-school because it gets you fit”, respectively.

Conclusions

Increasing specificity of correlate research has enabled the identification of unique features of, and a more in-depth interpretation of, lunchtime and after-school physical activity behaviour and is a potential strategy for advancing the physical activity correlate research field. The findings of this study could be used to inform and tailor gender-specific public health messages and interventions for promoting lunchtime and after-school physical activity in children.

Self-efficacy and enjoyment of middle school children performing the progressive aerobic cardiovascular endurance run (PACER)

Self-efficacy and enjoyment were examined among 34 middle school children (M age = 12.5 yr.) performing the Progressive Aerobic Cardiovascular Endurance Run (PACER). Exercise self-efficacy (running) and physical activity enjoyment were measured after viewing a video illustrating the PACER, and subsequently following a PACER test. Significantly greater pre- than post-exercise self-efficacy was reported; enjoyment scores did not differ. Ratings of self-efficacy were higher before exercise than after, but enjoyment scores were not significantly different. A significant correlation was found between post-exercise self-efficacy and enjoyment, but not between pre-exercise self-efficacy and enjoyment. Although positive correlations were found between PACER laps and pre-/post-exercise self-efficacy, correlations with ratings of enjoyment were not significant. Exercise self-efficacy was associated with children's beliefs about the task-specific PACER aerobic exercise; however, exercise enjoyment was stable. Children's self-efficacy and enjoyment beliefs should be considered when developing interventional strategies to promote aerobic exercise participation.

Role of suppressor variables in primary prevention obesity research: examples from two predictive models

Pediatric obesity is a pertinent public health challenge. Child physical activity and screen time behaviors enacted within the context of the family and home environment are important determinants of pediatric obesity. The purpose of this study was to operationalize five, maternal-facilitated, social cognitive theory constructs for predicting physical activity and screen time behaviors in children. A secondary purpose was to elucidate the function of suppressor variables in the design and implementation of family- and home-based interventions seeking to prevent pediatric obesity. Instrumentation included face and content validity of the measurement tool by a panel of experts, test-retest reliability of the theoretical constructs, and predictive validity of the constructs through structural equation modeling. Physical activity and screen time were modeled separately according to the five selected social cognitive theory constructs. Data were collected from 224 mothers with children between four and six years of age. Specification indices indicated satisfactory fit for the final physical activity and screen time models. Through a series of four procedures, the structural models identified emotional coping and expectations as suppressor variables for self-efficacy. Suppressor variables can complement program design recommendations by providing a suggested ordering to construct integration within an intervention.

Perceived environmental characteristics and psychosocial factors associated with physical activity levels in adolescents from Northeast Brazil: structural equation modelling analysis

This study aimed to investigate the direct and indirect associations between perceived environmental characteristics and psychosocial factors and physical activity levels in adolescents from Northeast Brazil. The sample was composed of 2,361 adolescents aged 14-19 years (56.6% female). Physical activity was measured using a questionnaire and environmental (perceived environmental characteristics) and psychosocial (self-efficacy, social support from parents and friends for physical activity) factors with previously validated scales. Perceived environmental characteristics were not directly associated with the levels of physical activity, but exhibited significant indirect associations, mediated by self-efficacy in males. Self-efficacy and social support were positively and directly associated with physical activity levels, and part of the associations between social support and physical activity was mediated by self-efficacy. Perception of self-efficacy and social support, important factors associated with physical activity levels in adolescents, should be the target of interventions aimed at increasing physical activity. Favorable environments for physical activity also need to be considered, since they have a positive influence on the self-efficacy of adolescents.

Autoeficácia e atividade física em adolescentes de Curitiba, Paraná, Brasil

Este trabalho teve o objetivo de analisar a associação entre atividade física e autoeficácia em adolescentes. Realizou-se um estudo inquérito de base escolar com 1.698 adolescentes de Curitiba, Paraná, Brasil. A atividade física foi avaliada segundo frequência semanal (dias/semana) de prática de atividade física de intensidade moderada ou vigorosa. A autoeficácia foi analisada segundo a soma de uma escala composta por dez itens. A associação entre autoeficácia e atividade física foi testada pela regressão de Poisson (p < 0,05), estratificada por sexo. Entre os meninos, apenas elevada autoeficácia foi associada com todas as categorias de atividade física (p < 0,001), enquanto para as meninas níveis moderados e elevados de autoeficácia foram associados com todas as categorias de atividade física (p < 0,001). Conclui-se que a autoeficácia tem associação positiva com atividade física entre adolescentes, no entanto esta relação é mais consistente entre as meninas. Este é um aspecto importante para o delineamento de intervenções para a promoção de atividade física nesse grupo populacional.

Measurement of general and specific approaches to physical activity parenting: a systematic review

BACKGROUND

Parents play a significant role in shaping youth physical activity (PA). However, interventions targeting PA parenting have been ineffective. Methodological inconsistencies related to the measurement of parental influences may be a contributing factor. The purpose of this article is to review the extant peer-reviewed literature related to the measurement of general and specific parental influences on youth PA.

METHODS

A systematic review of studies measuring constructs of PA parenting was conducted. Computerized searches were completed using PubMed, MEDLINE, Academic Search Premier, SPORTDiscus, and PsycINFO. Reference lists of the identified articles were manually reviewed as well as the authors' personal collections. Articles were selected on the basis of strict inclusion criteria and details regarding the measurement protocols were extracted. A total of 117 articles met the inclusionary criteria. Methodological articles that evaluated the validity and reliability of PA parenting measures (n=10) were reviewed separately from parental influence articles (n=107).

RESULTS

A significant percentage of studies used measures with indeterminate validity and reliability. A significant percentage of articles did not provide sample items, describe the response format, or report the possible range of scores. No studies were located that evaluated sensitivity to change.

CONCLUSION

The reporting of measurement properties and the use of valid and reliable measurement scales need to be improved considerably.

Physical activity behavior and related characteristics of highly active eighth-grade girls

PURPOSE

Although girls are generally less physically active than boys, some girls regularly engage in high levels of physical activity (PA); however, very little is known about these girls and how they differ from those who are less physically active. This study examined the PA behavior and related characteristics of highly active adolescent girls and compared them with those who are less active.

METHODS

Data from 1,866 eighth-grade girls from six field centers across the United States participating in the Trial of Activity for Adolescent Girls (TAAG) were included in the present analysis. Mixed-model analysis of variance examined differences in sociodemographic, anthropometric, psychosocial, and physical activity (accelerometry and self-report) variables between high- and low-active girls; effect sizes were calculated for the differences.

RESULTS

High-active girls were taller, had lower body mass indices and body fat, and were less sedentary. High-active girls scored higher on self-efficacy, enjoyment of PA, self-management strategies, outcome-expectancy value, and support from family and friends than low-active girls. Low-active girls participated in more leisure time and educational sedentary activities than high-active girls. High-active girls participated in more PA classes/lessons outside of school, team sports, and individual sports. They were also more likely to participate in sports in an organized setting in the community or at school than low-active girls.

CONCLUSIONS

Health promotion efforts should focus on decreasing the amount of time girls spend in sedentary activities and replacing that time with organized PA opportunities; such efforts should seek to minimize perceived barriers and increase self-efficacy and support for PA.

Construct validity of selected measures of physical activity beliefs and motives in fifth and sixth grade boys and girls

OBJECTIVE

Scales used to measure selected social-cognitive beliefs and motives for physical activity were tested among boys and girls.

METHODS

Covariance modeling was applied to responses obtained from large multi-ethnic samples of students in the fifth and sixth grades.

RESULTS

Theoretically and statistically sound models were developed, supporting the factorial validity of the scales in all groups. Multi-group longitudinal invariance was confirmed between boys and girls, overweight and normal weight students, and non-Hispanic black and white children. The construct validity of the scales was supported by hypothesized convergent and discriminant relationships within a measurement model that included correlations with physical activity (MET • min/day) measured by an accelerometer.

CONCLUSIONS

Scores from the scales provide valid assessments of selected beliefs and motives that are putative mediators of change in physical activity among boys and girls, as they begin the understudied transition from the fifth grade into middle school, when physical activity naturally declines.

Correlates of physical activity in adolescence: a study from a developing country

BACKGROUND

Physical activity is important for adolescent health. The current study aimed to explore factors that predict physical activity among adolescents.

METHODS

This was a cross-sectional study of physical activity among a sample of adolescents in Tabriz, Iran. Information on physical activity was collected using a modified version of the Adolescent Physical Activity and Recall Questionnaire (APARQ). In addition, a self-administrated questionnaire was used to collect data on demographic characteristics, perceived family support, and self-efficacy. Both univariate and multivariate logistic regression analyses were performed to examine the association between physical activity and independent variables including gender and psychosocial predictors.

RESULTS

In all, 402 students were studied. The mean age of adolescents was 12.93 (SD=0.49) years; 51.5% were female. The mean time of moderate and vigorous physical activity for all adolescents was 44.64 (SD=23.24) Metabolic Equivalent (MET) min per day. This figure for female adolescents was 38.77 (SD=19.94) MET min per day and for males it was 50.87 (SD=24.88) (P<0.001). The results obtained from multiple logistic regression analysis indicated that female gender (OR=2.59, 95% CI=1.46-4.57, P=0.001) and poor family support (OR=1.10, 95% CI=1.03-1.20, P=0.038) were the most significant contributing factors to low level physical activity in adolescents. Other variables studied did not show any significant results.

CONCLUSION

The findings from the current study indicated that female adolescents were at risk of lower level of physical activity. In addition, it was found that the lack of family support represented an increased risk for low-level physical activity. It seems that family support should be an integrated part of any health education/promotion programs for improving physical activity among young adolescents in general and for female adolescents in particular.

Psychosocial correlates of physical and sedentary activities of early adolescent youth

This study examines physical and sedentary activities of early adolescent boys and girls using Ecological Momentary Assessment (EMA), a method that can link mood and behaviors in specific social situations. Twenty-seven assessments were collected across 7 days from 82 participating adolescents, three times in seventh grade and one time in eighth grade. Assessments were completed during nonschool hours when youth had "free time." Gender differences, longitudinal trends, and associations of physical activities (PA) and small screen recreation (SSR) with moods and peer presence are examined. Boys were engaged in PA more than girls. Patterns of PA differed by gender; boys significantly decreased PA from seventh to eighth grade, whereas girls had increased PA only during the spring. PA was associated with happier mood and was more likely to occur in the presence of peers. SSR significantly increased from seventh grade to eighth grade for both boys and girls. SSR occurred more when youth were alone and was not associated with mood. Neither PA nor SSR was more likely to occur during weekdays or weekends. Implications for intervention efforts to increase PA in youth are discussed.

School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18

BACKGROUND

The World Health Organization (WHO) estimates that 1.9 million deaths worldwide are attributable to physical inactivity and at least 2.6 million deaths are a result of being overweight or obese. In addition, WHO estimates that physical inactivity causes 10% to 16% of cases each of breast cancer, colon, and rectal cancers as well as type 2 diabetes, and 22% of coronary heart disease and the burden of these and other chronic diseases has rapidly increased in recent decades.

OBJECTIVES

The purpose of this systematic review was to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents.

SEARCH METHODS

The search strategy included searching several databases to October 2011. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information.

SELECTION CRITERIA

To be included, the intervention had to be relevant to public health practice (focused on health promotion activities), not conducted by physicians, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, included all school-attending children, and be implemented for a minimum of 12 weeks. In addition, the review was limited to randomized controlled trials and those that reported on outcomes for children and adolescents (aged 6 to 18 years). Primary outcomes included: rates of moderate to vigorous physical activity during the school day, time engaged in moderate to vigorous physical activity during the school day, and time spent watching television. Secondary outcomes related to physical health status measures including: systolic and diastolic blood pressure, blood cholesterol, body mass index (BMI), maximal oxygen uptake (VO2max), and pulse rate.

DATA COLLECTION AND ANALYSIS

Standardized tools were used by two independent reviewers to assess each study for relevance and for data extraction. In addition, each study was assessed for risk of bias as specified in the Cochrane Handbook for Systematic Reviews of Interventions. Where discrepancies existed, discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated, and outcomes measured.

MAIN RESULTS

In the original review, 13,841 records were identified and screened, 302 studies were assessed for eligibility, and 26 studies were included in the review. There was some evidence that school-based physical activity interventions had a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally, school-based interventions had little effect on physical activity rates, systolic and diastolic blood pressure, BMI, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity resulted in positive effects.In this update, given the addition of three new inclusion criteria (randomized design, all school-attending children invited to participate, minimum 12-week intervention) 12 of the original 26 studies were excluded. In addition, studies published between July 2007 and October 2011 evaluating the effectiveness of school-based physical interventions were identified and if relevant included. In total an additional 2378 titles were screened of which 285 unique studies were deemed potentially relevant. Of those 30 met all relevance criteria and have been included in this update. This update includes 44 studies and represents complete data for 36,593 study participants. Duration of interventions ranged from 12 weeks to six years.Generally, the majority of studies included in this update, despite being randomized controlled trials, are, at a minimum, at moderate risk of bias. The results therefore must be interpreted with caution. Few changes in outcomes were observed in this update with the exception of blood cholesterol and physical activity rates. For example blood cholesterol was no longer positively impacted upon by school-based physical activity interventions. However, there was some evidence to suggest that school-based physical activity interventions led to an improvement in the proportion of children who engaged in moderate to vigorous physical activity during school hours (odds ratio (OR) 2.74, 95% confidence interval (CI), 2.01 to 3.75). Improvements in physical activity rates were not observed in the original review. Children and adolescents exposed to the intervention also spent more time engaged in moderate to vigorous physical activity (with results across studies ranging from five to 45 min more), spent less time watching television (results range from five to 60 min less per day), and had improved VO2max (results across studies ranged from 1.6 to 3.7 mL/kg per min). However, the overall conclusions of this update do not differ significantly from those reported in the original review.

AUTHORS' CONCLUSIONS

The evidence suggests the ongoing implementation of school-based physical activity interventions at this time, given the positive effects on behavior and one physical health status measure. However, given these studies are at a minimum of moderate risk of bias, and the magnitude of effect is generally small, these results should be interpreted cautiously. Additional research on the long-term impact of these interventions is needed.

Individual, social and physical environmental correlates of 'never' and 'always' cycling to school among 10 to 12 year old children living within a 3.0 km distance from school

Background

Cycling to school has been identified as an important target for increasing physical activity levels in children. However, knowledge about correlates of cycling to school is scarce as many studies did not make a distinction between walking and cycling to school. Moreover, correlates of cycling to school for those who live within a distance, that in theory would allow cycling to school, stay undiscovered. Therefore, this study examined individual, social and physical environmental correlates of never and always cycling to/from school among 10 to 12 year old Belgian children living within a 3.0 km distance from school.

Methods

850 parents completed a questionnaire to assess personal, family, behavioral, cognitive, social and physical environmental factors related to the cycling behavior of their children. Parents indicated on a question matrix how many days a week their child (1) walked, (2) cycled, was (3) driven by car or (4) public transport to and from school during fall, winter and spring. Multivariate logistic regression analyses were conducted to examine the correlates.

Results

Overall, 39.3% of children never cycled to school and 16.5% of children always cycled to school. Children with high levels of independent mobility and good cycling skills perceived by their parents were more likely to always cycle to school (resp. OR 1.06; 95% CI 1.04-1.15 and OR 1.08; 95% CI 1.01-1.16) and less likely to never cycle to school (resp. OR 0.84; 95% CI 0.78-0.91 and OR 0.77; 95% CI 0.7-0.84). Children with friends who encourage them to cycle to school were more likely to always cycle to school (OR 1.08; 95% CI 1.01-1.15) and less likely to never cycle to school (OR 0.9; 95% CI 0.83-1.0). In addition, children with parents who encourage them to cycle to school were less likely to never cycle to school (OR 0.78; 95% CI 0.7-0.87). Regarding the physical environmental factors, only neighborhood traffic safety was significantly associated with cycling: i.e., children were more likely to always cycle to school if neighborhood traffic was perceived as safe by their parents (OR 1.18; 95% CI 1.07-1.31).

Conclusion

Individual, social and physical environmental factors were associated with children’s cycling behavior to/from school. However, the contribution of the physical environment is limited and highlights the fact that interventions for increasing cycling to school should not focus solely on the physical environment.

The association of self-efficacy and parent social support on physical activity in male and female adolescents

OBJECTIVE

Previous research has shown that cognitive factors may account for the relationship between interpersonal factors and health behaviors. Given these findings, the current study sought to further explore the direct and indirect relationship between parental social support and adolescent physical activity (PA).

METHOD

Data were collected from 1,421 sixth graders (73% Black, 54% females, 71% on free or reduced lunch) in South Carolina. Measures for emotional social support, instrumental social support, and adolescent self-efficacy (SE) were assessed and PA was assessed via accelerometry.

RESULTS

Parent instrumental social support was directly related to girls' PA and parent emotional social support was inversely related to girls' PA. Parent instrumental social support was indirectly related to boys' PA through boys' SE. The covaried association of SE with PA was significant for boys and marginal for girls.

CONCLUSIONS

SE for overcoming barriers may be an important construct for understanding the relationship between parent instrumental social support and boys' PA in underserved populations. The mechanisms for engaging in PA may be different for adolescent girls and boys.

A review of family and environmental correlates of health behaviors in high-risk youth

Disparities in the prevalence of obesity in youth place minority and low socioeconomic status youth at increased risk for the development of chronic disease, such as metabolic syndrome and type 2 diabetes. Contributing factors to the increases in obesity include a decline in positive health behaviors, such as making healthy dietary choices, engaging in physical activity, and limiting sedentary behaviors. Family and physical environmental contextual factors related to health behaviors are increasingly the focus of health behavior interventions in line with the bioecological model that encourages a system-focused perspective on understanding health behavior influences. Physical environmental characteristics, such as home and neighborhood characteristics and resources, provide the tangible means to support health behaviors and are important contextual variables to consider that may increase intervention effectiveness. Therefore, the current review seeks to highlight the importance of investigating influences of behavior beyond individual characteristics in understanding factors related to the risk of developing metabolic syndrome and type 2 diabetes in youth at high risk for developing chronic disease. The current study reviews the non-intervention literature on family and physical environmental factors related to health behaviors (i.e., diet, physical activity, and sedentary behavior) in youth who are considered to be at-risk for developing metabolic syndrome and type 2 diabetes. Results on 38 published articles of diet, physical activity, and sedentary behaviors showed support for the role of parenting and physical environmental factors, particularly parental monitoring and neighborhood context, such as social cohesion, as they relate to health behaviors in high-risk youth. Implications and recommendations for future research are discussed.

Assessing the social and physical contexts of children's leisure-time physical activity: an ecological momentary assessment study

PURPOSE

To use Ecological Momentary Assessment with mobile phones to describe where and with whom children's leisure-time physical activity occurs.

DESIGN

Repeated assessments across 4 days (Friday-Monday) during nonschool time (20 total).

SETTING

Chino, California, and surrounding communities.

SUBJECTS

Primarily low to middle income children (N =121; aged 9-13 years; x¯=11.0 years, SD =1.2 years; 52% male, 38% Hispanic/Latino).

MEASURES

Electronic surveys measured current activity (e.g., active play/sports/exercise, watching TV/movies), social company (e.g., family, friends, alone), physical location (e.g., home, outdoors, school), and other perceived contextual features (e.g., safety, traffic, vegetation, distance from home). Analysis . Multilevel linear and multinomial logistic regression.

RESULTS

Most of children's physical activity occurred outdoors (away from home) (42%), followed by at home (indoors) (30%), front/backyard (at home) (8%), someone else's house (8%), at a gym/recreation center (3%), and other locations (9%). Children's physical activity took place most often with multiple categories of people together (e.g., friends and family) (39%), followed by family members only (32%), alone (15%), and with friends only (13%). Age, weight status, income, and racial/ethnic differences in physical activity contexts were observed.

CONCLUSIONS

The most frequently reported contexts for children's leisure time physical activity were outdoors and with family members and friends together.

Design of a website on nutrition and physical activity for adolescents: results from formative research

Background

Teens do not meet guidelines for healthy eating and physical activity. The Internet may be an effective method for delivering programs that help them adopt healthy behaviors.

Objective

To collect information to design content and structure for a teen-friendly website promoting healthy eating and physical activity behaviors.

Methods

Qualitative research, encompassing both focus group and interview techniques, were used to design the website. Participants were 12-17 year olds in Houston, Texas, and West Lafayette, Indiana.

Results

A total of 133 participants took part in 26 focus groups while 15 participated in one-on-one interviews to provide guidance for the development of teen-friendly content and structure for an online behavior change program promoting healthy eating and physical activity to 12-17 year olds. The youth made suggestions to overcome common barriers to healthy eating and physical activity. Their feedback was used to develop “Teen Choice: Food & Fitness,” a 12-week online behavior change program, populated by 4 cartoon character role models.

Conclusions

It is critical that members of the target audience be included in formative research to develop behavior change programs that are relevant, appealing, and address their needs and interests.