Personal, behavioral, and socio-environmental correlates of physical activity among adolescent girls: cross-sectional and longitudinal associations

Social Determinants of Health and Health Equity in the Treatment and Rehabilitation of Sport-Related Concussion: A Content Analysis of Intervention Research and Call-To-Action

This review was designed to (1) determine the extent to which the clinical science on sport-related concussion treatment and rehabilitation has considered social determinants of health (SDoH) or health equity and (2) offer recommendations to enhance the incorporation of SDoH and health equity in concussion treatment research and clinical care. The Concussion in Sport Group consensus statement (2023) was informed by two systematic reviews examining prescribed rest or exercise following concussion and targeted interventions to facilitate concussion recovery. We examined 31 studies, including 2,698 participants, from those two reviews. Race (k = 6; 19.4%) and ethnicity (k = 4; 12.9%) of the study samples were usually not reported. Four studies examined ethnicity (i.e., Hispanic), exclusively as a demographic category. Five studies (16.1%) examined race as a demographic category. Three studies (9.7%) examined socioeconomic status (SES; measured as household income) as a demographic category/sample descriptor and one study (3.2%) examined SES in-depth, by testing whether the treatment and control groups differed by SES. Five studies examined an SDoH domain in a descriptive manner and four studies in an inferential/intentional manner. No study mentioned SDoH, health equity, or disparities by name. Many studies (61.3%) excluded participants based on demographic, sociocultural, or health factors, primarily due to language proficiency. The new consensus statement includes recommendations for concussion treatment and rehabilitation that rely on an evidence base that has not included SDoH or studies addressing health equity. Researchers are encouraged to design treatment and rehabilitation studies that focus specifically on underrepresented groups to determine if they have specific and unique treatment and rehabilitation needs, whether certain practical modifications to treatment protocols might be necessary, and whether completion rates and treatment adherence and response are similar.

Peer effects in weight-related behaviours of young people: A systematic literature review

Individual preferences and beliefs are perpetually shaped by environmental influences, with peers playing a key role in this dynamic process. Compelling evidence from qualitative and quantitative studies has highlighted the significant impact of peer influence on health-related decisions. This systematic literature review critically synthesises findings from 45 studies published between 2011 and 2022, providing a comprehensive understanding of the nature of peer effects on dietary, physical activity and sleep behaviours during youth. The majority of studies indicated that social norms drive directional changes in eating and physical activity. Yet, our analysis revealed a notable gap in exploring alternative mechanisms, including social comparison and social identity, despite their potential relevance. Studies, generally classified as moderate to high quality, predominantly relied on self-reported data, potentially affecting the validity and reliability of measures. Meta-regression analyses suggest a small, but significant association of sample size with the magnitude, sign and significance of the reported peer effects. Moreover, studies focusing on physical activity are more likely to report significant outcomes, whereas findings on peer influence on sleep-related studies tend to reveal less pronounced effects, compared to studies on dietary behaviours. Experimental designs do not appear to increase the likelihood of finding significant effects when compared to other study designs. In conclusion, this synthesis emphasises the need for further research into the underlying mechanisms on peer effects to better inform policy-makers in designing effective policies for improving weight-related behaviours in young people.

Long-term recreational exercise patterns in adolescents and young adults: Trajectory predictors and associations with health, mental-health, and educational outcomes

Individual and societal factors influencing the formation of long-term recreational exercise habits during the transition from adolescence to young adulthood are not well explored. Using data from the Longitudinal Survey of Australian Youth (LSAY), a population-representative cohort study of Young People followed from age 15 to 25, we aimed to (1) model longitudinal recreational exercise trajectories from age 16 to 24, (2) examine predictors at age 15 of entering these trajectories, and (3) explore the association between the trajectories and health, mental health and educational achievement outcomes measured at the final study wave (age 25). Self-reported recreational exercise frequency data from 9353 LSAY participants were analysed using group-based trajectory modelling. We modelled the evolution of two patterns of recreational exercise behaviour: daily exercise, as per public health guidelines (Model 1); and at least once weekly exercise (Model 2). Model 1 trajectories were guideline-adherent exercisers (17.9% of the sample), never guideline exercisers (27.5%), guideline drop-outs (15.2%) and towards guideline (39.4%); Model 2 trajectories were weekly exercise (69.5% of the sample), decreasing (17.4%), increasing (4.8%), and infrequent (8.3%). For both models, at age 15, trajectory membership was predicted by gender, self-efficacy, time spent participating in sport, time spent watching TV, parental socioeconomic status, and academic literacy. At age 25, people in the guideline-adherent exerciser trajectory (model 1) reported better general health relative to other trajectories, Those in the weekly exerciser trajectory (model 2) had better general health and reduced rates of psychological distress, were happier with life and were more optimistic for the future relative to participants in less than weekly trajectory groups. Exercise-promoting interventions for Young People should specifically address the needs of females, people with low self-efficacy, reluctant exercisers, higher academic achievers, and those experiencing socioeconomic disadvantage.

See Me, Hear Me, Know Me: Perspectives on Diet and Physical Activity Influences among Teens Living in Rural Texas Communities

Teens in rural communities are at greater risk of obesity than teens in urban areas. Diet and physical activity influence obesity risk. Understanding their perspectives is an important step in intervention design. This qualitative investigation explored teen perspectives on how living in a rural community influenced their diet and physical activity choices. Forty parent-teen pairs were recruited. Data collection included surveys and telephone interviews. This paper reports teen perspectives identified in the first interview. Thematic analysis was used to code and analyze the data. Findings revealed that the primary factor driving teens' diet and physical activity behaviors was the teens themselves. They clearly understood their role in the choices they made, although they acknowledged not always making the healthiest choice. This belief was driven by their motivation to engage in healthy behaviors, which was influenced by the perceived benefits derived from making healthy choices and from the synergistic relationship between diet and physical activity. Diet and physical activity, in turn, were influenced by the environment, particularly the home, social, and community environments. Family and friends were particularly influential, as well as resource availability. These findings can serve as a foundation for designing interventions tailored to this population.

Virtual reality assessment of walking in a modifiable urban environment: a feasibility and acceptability study

Physical activity is known to be one of the most health-beneficial behaviors, and salutogenic design modifications to the built environment can facilitate increased physical activity. Unfortunately, it is not often clear in advance which environmental and urban design implementations will generate increases in activities such as walking, and which will have little impact or even reduce walking. The present study tested the feasibility and acceptability of a virtual reality (VR) model for pre-testing urban designs for their impact on walking. Using a wearable VR head-mounted display/computer, young adults (n = 40) walked freely through a large indoor gymnasium, simultaneously walking through a virtual model of an urban streetscape that was designed to be modifiable and allow for testing impacts on walking of various changes to the urban environment. The majority of participants found the experience to be acceptable: pleasant and nonaversive, and they walked freely through the VR model for approximately 20 min, on average. Using modifiable VR models to pre-test built-environment changes for their impacts on walking behavior appears to be a feasible and acceptable approach and worthy of continued research investigation.

Body image and health-related behaviors among fitspirit participants

Background

Body image variables such as body size perception (BSP) and body size dissatisfaction (BSD) can influence health-related behaviors. However, few studies have investigated these body image variables in adolescent girls participating in a physical activity intervention. Therefore, the study objectives were to examine the 1) associations between health-related behaviors (physical activity, screen-time, eating habits and sleep duration) and BSP and BSD among girls participating in FitSpirit, a physical activity intervention for girls; and 2) influence of weight control practices on the association between health-related behaviors and BSP and BSD.

Methods

This cross-sectional study assessed a sample of 545 adolescent girls (mean age: 15.0±1.5 years) from 240 schools. Body mass index, health-related behaviors, perceived actual body size and desired body size variables were self-reported and collected via an online questionnaire at the end of the FitSpirit intervention. A negative BSP score [perceived actual body size – calculated BMI z-score] indicates an underestimation of body size. A positive BSD score [perceived actual body size – desired body size] indicates a desire to reduce body size. A multiple linear regression analysis examined the effects of age, zBMI and health behaviors on BSP and BSD. A second multiple linear regression analysis examined the independent associations between BSP and BSD by weight control practice. The linear relationships between BSP and BSD were evaluated with Pearson’s correlations.

Results

Underestimation and dissatisfaction of body size are more prevalent in participants living with overweight/obesity. Screen-time and sleep duration were independently associated with BSP score (Beta=0.02; P<0.05 and Beta=-0.07; P<0.05, respectively), whereas only screen-time was associated with the BSD score (Beta=0.07; P<0.001). Physical activity was independently associated with the BSP score only in participants trying to control (maintain) their weight (Beta=-0.18; P<0.05).

Conclusions

Body size overestimation and dissatisfaction are associated with health-related behaviors, specifically with more screen-time and less optimal sleeping habits. Physical activity level does not appear to be associated with body image in girls engaged in a physical activity intervention and who want to lose or gain weight. Health promotion interventions could include screen-time and sleep components as they may influence body image.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Urban green spaces in the proximity of residences can reduce the effect of socioeconomic inequalities in sports practice among teenage girls

Background

We studied if proximity of urban green spaces to residences reduces the socioeconomic inequalities in sports practice, evaluating 17-year-old girls (n = 722) from EPITeen cohort, Porto, Portugal.

Methods

The shortest routes from residences to urban green spaces were calculated using the street network from Geographic Information System. Distances were classified as: ≤400, >400 to ≤800, and >800 m. Parental education was used as a proxy of socioeconomic status (SES). We used chi-square test to compare proportions of teenagers practicing sports per SES, stratified by classes of distances to urban green spaces and logistic regression to estimate the association between sports practice and SES through odds ratio (OR) and 95% confidence intervals.

Results

Strong inequalities were found. Girls from low SES have ≥75% less odds of sports practice (reference: high SES), regardless of the distance to urban green spaces. As distances are lowering the socioeconomic inequalities in the sports practice between girls from high and medium SES diminishes, being the OR 0.42 (0.22-0.80) at ≥800 m, 0.51 (0.24-1.09) at ≥400 to ≤800 m, and 0.63 (0.29-1.37) at ≤400 m.

Conclusion

At closer distances inequalities in the proportion of sports practice between high and medium SES vanishes, but remain to low SES.

The school policy, social, and physical environment and change in adolescent physical activity: An exploratory analysis using the LASSO

PURPOSE

We examined the association between the school policy, social and physical environment and change in adolescent physical activity (PA) and explored how sex and socioeconomic status modified potential associations.

METHODS

Data from the GoActive study were used for these analyses. Participants were adolescents (n = 1765, mean age±SD 13.2±0.4y) from the East of England, UK. Change in longitudinal accelerometer assessed moderate-to-vigorous physical activity (MVPA) was the outcome. School policy, social and physical environment features (n = 267) were exposures. The least absolute shrinkage and selection operator variable selection method (LASSO) was used to determine exposures most relevant to the outcome. Exposures selected by the LASSO were added to a multiple linear regression model with estimates of change in min/day of MVPA per 1-unit change in each exposure reported. Post-hoc analyses, exploring associations between change in variables selected by the LASSO and change in MVPA, were undertaken to further explain findings.

FINDINGS

No school policy or physical environment features were selected by the LASSO as predictors of change in MVPA. The LASSO selected two school social environment variables (participants asking a friend to do physical activity; friend asking a participant to do physical activity) as potential predictors of change in MVPA but no significant associations were found in subsequent linear regression models for all participants (β [95%CI] -1.01 [-2.73;0.71] and 0.65 [-2.17;0.87] min/day respectively). In the post-hoc analyses, for every unit increase in change in participants asking a friend to do PA and change in a friend asking participants to do PA, an increase in MVPA of 2.78 (1.55;4.02) and 1.80 (0.48;3.11) min/day was predicted respectively.

CONCLUSIONS

The school social environment is associated with PA during adolescence. Further exploration of how friendships during adolescence may be leveraged to support effective PA promotion in schools is warranted.

Peer Support and Role Modelling Predict Physical Activity Change among Adolescents over Twelve Months

Physical activity levels decline during adolescence; however, some individuals initiate or maintain physical activity participation during this period of life. Socialisation impacts physical activity participation, yet few studies have explored the role of parental and peer processes concurrently on youth physical activity transitions over time. This study examined whether mother's father's and friends' support, modelling and teasing predicted adolescents' physical activity initiation, drop-off or maintenance over twelve months. In total, 803 adolescents (62.5% females, M age = 13.72) from Dublin, Ireland, completed self-report measures of support, modelling, teasing, and physical activity. Participants were classified as physical activity maintainers (17.8%), low active maintainers (58.8%), drop-offs (10.3%) or physical activity initiators (13.1%). The results revealed that parental support and modelling were unrelated to adolescents' physical activity transitions, however mother's and father's support predicted sustained physical activity participation twelve months later. In contrast, peer processes predicted physical activity maintenance, initiation and drop-off at one-year follow-up underscoring the salient role of peers for adolescents' behaviour change. In line with expectancy-value theory, the findings indicate that parents and peers represent distinct socialising agents that impart their influence on adolescents' physical activity maintenance and behaviour change through various mechanisms, highlighting the need to consider both sources of socialisation concurrently in future studies of adolescent behaviour change.

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.

Which School Community Agents Influence Adolescents' Motivational Outcomes and Physical Activity? Are More Autonomy-Supportive Relationships Necessarily Better?

The first aim of this work was to examine the independent influence of students' perceived autonomy support for leisure-time physical activity (LTPA), from different school community agents, on motivational outcomes in a LTPA context and objective PA levels. Using both a variable- and person-centered approach, the second aim was to examine how different combinations of autonomy-support were associated with students' motivational outcomes in a LTPA context and PA levels. A sample of 178 secondary students (M = 13.26 ± 0.64) participated in the study. Autonomy support for LTPA from the PE teacher, mother, father, and peers were the only agents that significantly and positively predicted motivational outcomes in a LTPA context and PA levels. While the two- and three-way interactions of some of these four significant sources significantly increased the explained variance of some motivational outcomes, the plots revealed that the lowest values of motivational outcomes were associated with low values of perceived autonomy support. A cluster analysis revealed five profiles. The "high autonomy support" group reported the most optimal outcomes, whereas the "low autonomy support" group showed the opposite pattern. However, mixed autonomy support profiles did not differ in any of the outcomes. The adoption of a whole-of-school approach seems decisive to empower adolescents to be active in and out of school.

Physical Activity Intensity Among Adolescents and Association With Parent-Adolescent Relationship and Well-Being

Participation in physical activity (PA) provides young people significant health benefits, including improved well-being. However, large percentages of children and adolescents do not meet the recommendations for PA. Given that PA patterns are established during childhood and adolescence, and evolve within the context of the family, the current study explores the relationship between perceived parent–adolescent relationships and adolescents’ PA levels, body mass index (BMI), and subjective well-being. The study was conducted in Israel, and the sample included 233 participants (126 girls, 107 boys) aged 13 to 18 years.

Participants self-reported the following measures: demographic information, BMI, the Godin-Shephard Leisure-Time Physical Activity Questionnaire, the Personal Well-Being Index, and parent–adolescent relationship. The data were analyzed using Pearson analyses, t tests, and regressions. A clear difference emerged in strenuous PA activity by sex [t(₂₂₃) = 2.1, p < .01]; the average strenuous PA was greater for boys (M = 3.9, SD = 2.4) than for girls (M = 1.8, SD = .2.4). Furthermore, different predictors of strenuous PA by sex were found: for boys, parent–adolescent relationship was a significant predictor; for girls, subjective well-being was a predictor. The findings can shed light on the need for different intervention programs for adolescent boys and girls to increase their involvement in PA.

Environment perception and leisure-time physical activity in Portuguese high school students

This study aims to analyze the association between perceived environmental factors and leisure-time physical activity (PA) among adolescents of both genders. Data were collected in autumn of 2011 from 866 adolescents (412 girls and 454 boys) 12- to 18-years-old, from four Portuguese cities. Perception of environmental factors was assessed by Assessing Levels of Physical Activity and Fitness (ALPHA) questionnaire (Spittaels et al., 2010, IJBNPA). PA was assessed by a questionnaire that evaluated PA during leisure-time and participants were assigned into the following categories: sedentary; low active; moderate active; and very active. Boys presented higher levels of structured PA, frequency and intensity of PA, and level of sport competition than girls (p < 0.001). Distance to local facilities (p = 0.001 for girls; p < 0.001 for boys) and home environment (p = 0.004 for girls; p = 0.015 for boys) were negatively associated with PA. Total, cycling and walking infrastructures (p < 0.001), as well as cycling and walking network (p = 0.049) and connectivity (p = 0.034) showed a positive association with PA in boys. Analysis of variance showed significant differences between girls' PA regarding aesthetics (p = 0.013), study environment (p = 0.023), home environment (p = 0.014) and whether it is pleasant or not (p = 0.023). Differences between boys' PA were observed for distance to local facilities (p = 0.003), total, cycling and walking infrastructures (p < 0.001) and home environment (p = 0.002). This study results support that some environmental factors are associated with adolescents' PA levels, with relevant differences between genders. Therefore, these gender differences must be taken into account, in order to increase levels of PA in Portuguese youth, especially in girls.

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Portuguese adolescents' physical activity levels remain extremely low.

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Adolescent boys present higher levels of physical activity than girls.

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Several environmental factors are associated with adolescents' physical activity.

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Perceptions about the environment are different between genders.

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Boys and girls' physical activity is related with different environmental factors.

Individual and School Correlates of Adolescent Leisure Time Physical Activity in Quebec, Canada

Background: Leisure time physical activity (LTPA) correlates have been mostly studied in relation to adolescents’ home neighbourhoods, but not so much in relation to the environment of their schools’ neighbourhoods. We sought to investigate how objective environmental measures of the schools’ vicinity are related to adolescents’ self-reported LTPA. Methods: Individual data from the Quebec High School Students Health Survey (QHSSHS) were matched with schools’ socioeconomic indicators, as well as geographic information system-based indicators of their built environments. Self-reported levels of LTPA during the school year were assessed according to intensity, frequency and index of energy expenditure. Associations per gender between covariates and LTPA were estimated using ordinal multilevel regression with multiple imputations. Results: Boys (21% of which were highly active) were more active than girls (16% of which were highly active) (p ≤ 0.01). The incremental variance between schools explained by the contextual variables in the final models was higher among girls (7.8%) than boys (2.8%). The number of parks or green spaces within 750 m around their schools was positively associated with student LTPA in both genders. Conclusions: The promotion of parks around schools seems to be an avenue to be strengthened.

Adolescent obesity in contextual settings: a scoping study of multilevel and hierarchical examinations

Multilevel/hierarchical obesity studies analyze adolescent and family, neighbourhood and social settings' characteristics to generate data needed to design prevention interventions. This scoping study summarizes such studies' characteristics and key findings to provide information to decision makers, which allows them to quickly grasp the state of the evidence and potential policy implications for adolescent obesity prevention. PubMed, CINAHLplus, PsychINFO and Sociological Abstracts were searched for peer-reviewed studies spanning 1 January 2000-31 August 2014. Inclusion criteria included (i) outcome weight status, physical activity and weight status, or physical activity alone if the aim was obesity prevention; (ii) 12- to 19-year-old participants in a cross-sectional study, a separate analysis in a cross-sectional study or a longitudinal follow-up. Nineteen studies were published in the United States of America; four in Canada; two in Spain, China and Vietnam, respectively; and one in Germany. Self-efficacy, parental physical activity support, perceived neighbourhood support, social cohesion and access to recreational facilities were associated with increased activity levels; neighbourhood physical disorder and perceived lack of safety associated with reduced physical activity levels. Overweight or obesity was associated with sugar-sweetened beverage intake and household availability thereof; reduced odds were reported with fruit and vegetable intake and household availability of these, daily breakfast and family meal frequency. Potential adolescent obesity risk regulators may be found at the individual, family or social contextual levels.

Obesogenic behaviours and depressive symptoms in children: a narrative literature review

This review examines peer-reviewed, published articles exploring the role of obesogenic behaviours, including physical activity, screen time, and diet, and depressive symptoms, in 6- to 12-year-old children. Searches were conducted March-May 2014 and in August 2015 using PubMed, PsychInfo, and Embase. Eligible studies published between January 1990-August 2015 included 8- to 12-year-old children, any of the three previously identified obesogenic behaviours, and a measure of depressive symptoms. The search yielded 415 articles that were screened and assessed for eligibility; 21 were retained. Some studies included depression and a single obesogenic behaviour, while others included multiple obesogenic behaviours. Fifteen studies assessed physical activity, twelve assessed screen time, and five assessed dietary intake. Lower physical activity was associated with higher depression in 80% of studies. Higher screen time was associated with higher depression in all studies. Poor dietary intake was associated with higher depression in 60% of studies. Significant associations were found between depression and all three obesogenic behaviours. Stronger associations were found between depression and physical activity and screen time than between depression and dietary intake. This review broadens the understanding of the relationship between obesogenic behaviours and depression, and shows outcome consistency despite the lack of a consistent measurement technique. © 2016 World Obesity.

A quasi-experimental examination of how school-based physical activity changes impact secondary school student moderate- to vigorous- intensity physical activity over time in the COMPASS study

Background

Adolescence is characterized by low moderate- to vigorous- intensity physical activity (MVPA) levels. Targeting the school setting can increase MVPA among a large proportion of adolescents. However, school-based physical activity interventions for adolescents remain largely ineffective. Therefore, the purpose of this study was to examine how naturally-occurring changes to school physical activity policy, recreational programming, public health resources, and the physical environment, impact adolescent MVPA over a 1-year period.

Methods

Quasi-experimental longitudinal data from 18,777 grade 9–12 students (mean age = 15.1 ± 0.02 years), and 86 principals from 86 schools, participating in year 2 (2013–2014) and year 3 (2014–2015) of the COMPASS study (Ontario and Alberta, Canada) was used. Total MVPA over the previous week was self-reported at both time points using the COMPASS Student Questionnaire and average daily MVPA was calculated. Changes to physical activity policies, recreational programming, public health resources, and the physical environment were self-reported by school principals. Changes to the number and condition of physical activity facilities were objectively measured during school audits using the COMPASS School Environment Application. Multi-level modeling was used to examine change in student MVPA between schools that made changes and schools that did not. Models were adjusted for several student and school level confounders.

Results

Over the 1-year period, 61 of 86 schools made physical activity related changes. Of these, 9 significantly changed student MVPA. However, only 4 of 9 schools’ changes increased student MVPA, including opening the fitness centre at lunch (β = 17.2, 95 % CI: 2.6–31.7), starting an outdoor club (β = 17.8, 95 % CI:7.4–28.1), adding a bike rack (β–14.9, 95 % CI:0.7–29.1), and adding weightlifting and run/walk clubs, archery, figure skating, increased access to the sports field, and improved condition of the outdoor basketball court (β = 15.5, 95 % CI: 5.2–25.7).

Conclusions

Changes such as adding or increasing access to facilities, and adding multiple recreational programs, seemed to be effective for increasing student MVPA over the 1-year period. However, given the specificity of results, a one-size fits all approach may not be effective for increasing MVPA. Instead, school principals need to consider the resources within and surrounding their school, and the interests of the students.

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.

Correlates of Insufficient Physical Activity among Junior High School Students: A Cross-Sectional Study in Xi'an, China

Background: Physical activity plays an important role in individual health at all stages of life. However, evidence is lacking regarding the level of moderate to vigorous physical activity (MVPA) and the related factors to insufficient physical activity (IPA). Methods: A sample of 1060 students aged 12–15 years from nine public junior high schools in China were invited to participate in this study. Physical activity was assessed by a modified version of the International Physical Activity Questionnaire. Logistic regression was used to assess the factors associated with IPA. Results: 30.1% boys and 43.0% girls in our sample did not engage in sufficient physical activity. Obesity (OR = 2.2, 95% CI: 1.5–2.9) and high socioeconomic status (SES) (OR = 2.4, 95% CI: 1.3–4.8) were positively associated with IPA, whereas male sex (OR = 0.7, 95% CI: 0.5–0.9), underweight status (OR = 0.5, 95% CI: 0.3–0.7), and high family support level for physical activity (OR = 0.7, 95% CI: 0.6–0.9) showed inverse associations. Age was not associated with IPA. Conclusions: IPA appears to be a considerable problem in this sample of Chinese youth. Effective interventions to increase physical activity are needed and may include improving family support level for physical activity, especially for girls, the obese and those with high SES.

The school environment and adolescent physical activity and sedentary behaviour: a mixed-studies systematic review

There is increasing academic and policy interest in interventions aiming to promote young people's health by ensuring that the school environment supports healthy behaviours. The purpose of this review was to summarize the current evidence on school-based policy, physical and social-environmental influences on adolescent physical activity and sedentary behaviour. Electronic databases were searched to identify studies that (1) involved healthy adolescents (11-18 years old), (2) investigated school-environmental influences and (3) reported a physical activity and/or sedentary behaviour outcome or theme. Findings were synthesized using a non-quantitative synthesis and thematic analysis. Ninety-three papers of mixed methodological quality were included. A range of school-based policy (e.g. break time length), physical (e.g. facilities) and social-environmental (e.g. teacher behaviours) factors were associated with adolescent physical activity, with limited research on sedentary behaviour. The mixed-studies synthesis revealed the importance of specific activity settings (type and location) and intramural sport opportunities for all students. Important physical education-related factors were a mastery-oriented motivational climate and autonomy supportive teaching behaviours. Qualitative evidence highlighted the influence of the wider school climate and shed light on complexities of the associations observed in the quantitative literature. This review identifies future research needs and discusses potential intervention approaches to be considered.

Higher screen time is associated with overweight, poor dietary habits and physical inactivity in Brazilian adolescents, mainly among girls

OBJECTIVES

To analyse the associations between high screen time and overweight, poor dietary habits and physical activity in adolescents according to sex.

METHODS

The study comprised 515 boys and 716 girls aged 14-17 years from Londrina, Brazil. Nutritional status (normal weight or overweight/obese) was assessed by calculating the body mass index. Eating habits and time spent in physical activity were reported using a questionnaire. The measurement of screen time considered the time spent watching television, using a computer and playing video games during a normal week. Associations between high screen time and dependent variables (nutritional status, eating habits and physical activity levels) were assessed by binary logistic regression, adjusted for sociodemographic and lifestyle variables.

RESULTS

Most adolescents (93.8% of boys and 87.2% of girls) spent more than 2 hours per day in screen-time activities. After adjustments, an increasing trend in the prevalence of overweight and physical inactivity with increasing time spent on screen activities was observed for both sexes. Screen times of >4 hours/day compared with <2 hours/day were associated with physical inactivity, low consumption of vegetables and high consumption of sweets only in girls and the consumption of soft drinks in both sexes.

CONCLUSIONS

The frequency of overweight and physical inactivity increased with increasing screen time in a trending manner and independently of the main confounders. The relationship between high screen time and poor eating habits was particularly relevant for adolescent girls.

Screen-based media use clusters are related to other activity behaviours and health indicators in adolescents

Background

Screen-based media (SBM) occupy a considerable portion of young peoples’ discretionary leisure time. The aim of this paper was to investigate whether distinct clusters of SBM use exist, and if so, to examine the relationship of any identified clusters with other activity/sedentary behaviours and physical and mental health indicators.

Methods

The data for this study come from 643 adolescents, aged 14 years, who were participating in the longitudinal Western Australian Pregnancy Cohort (Raine) Study through May 2003 to June 2006. Time spent on SBM, phone use and reading was assessed using the Multimedia Activity Recall for Children and Adults. Height, weight, muscle strength were measured at a clinic visit and the adolescents also completed questionnaires on their physical activity and psychosocial health. Latent class analysis (LCA) was used to analyse groupings of SBM use.

Results

Three clusters of SBM use were found; C1 ‘instrumental computer users’ (high email use, general computer use), C2 ‘multi-modal e-gamers’ (both high console and computer game use) and C3 ‘computer e-gamers’ (high computer game use only). Television viewing was moderately high amongst all the clusters. C2 males took fewer steps than their male peers in C1 and C3 (-13,787/week, 95% CI: -4619 to -22957, p = 0.003 and -14,806, 95% CI: -5,306 to -24,305, p = 0.002) and recorded less MVPA than the C1 males (-3.5 h, 95% CI: -1.0 to -5.9, p = 0.005). There was no difference in activity levels between females in clusters C1 and C3.

Conclusion

SBM use by adolescents did cluster and these clusters related differently to activity/sedentary behaviours and both physical and psychosocial health indicators. It is clear that SBM use is not a single construct and future research needs to take consideration of this if it intends to understand the impact SBM has on health.