Participation in physical activity and sport in adolescent girls from Middle Eastern backgrounds

OBJECTIVES

This study investigated the barriers and facilitators to physical activity and sport participation among adolescent girls from Middle Eastern backgrounds. These factors were explored through the perspectives of both adolescent girls and parents of adolescent girls, living in Australia.

DESIGN

A qualitative study design was used to understand perceived barriers and facilitators to physical activity and sport in adolescent girls. Participants were 18 adolescent girls and 9 parents of adolescent girls, all of Middle Eastern backgrounds, living in Western Sydney, Australia. Data were collected through five focus groups and four one-on-one interviews, separated for girls and parents. Data were analysed using an inductive approach and thematic analysis.

RESULTS

Three main themes (family, social support, religion and culture) and nine subthemes were identified. The main facilitators for physical activity and sport included the values and presence of an active family role model, religion to encourage lifelong physical activity skills, and promotion of physical activity from peers, school, and social media. The predominant barriers to physical activity and sport included established cultural norms and traditional gender roles, which were often influenced by religion and culture, and extended time using technology.

CONCLUSION

The findings of the current study show the complex relationships between family, religion, and culture when promoting physical and sport participation. Such factors highlight the need to develop culturally tailored physical activity interventions that consider the perceived barriers and facilitators for adolescent girls' participation from Middle Eastern backgrounds.

"You are either sporty or you are not" A Qualitative Exploration of Pre-Teen Girls of Low-Socioeconomic Position Experiences of Being Physically Active

BACKGROUND

Eighty one percent of adolescents do not meet the recommended physical activity (PA) guidelines with levels of physical activity declining steadily with age and more pronounced in girls of low socioeconomic position (SEP). Furthermore, early adolescence is a time when the rate of decline in PA is most severe amongst girls, placing them at an increased likelihood of developing negative health outcomes associated with physical inactivity. In response, the aim of this study was to explore low-SEP pre-teen girls' experiences of being physically active and to understand their perceptions of the individual, social and environmental factors that influence these experiences.

METHODS

Focus groups were conducted with 107 girls aged 10 - 12 years from four urban and three rural primary schools. Reflexive thematic analysis was used to analyse the data, with themes mapped to the relevant domains of the Theoretical Domains Framework (TDF).

RESULTS

Themes highlighted how skills and confidence underpin girls' self-identity for PA. Girls described how their social network (i.e., peers, family, coaches and teachers) shaped their experiences of being active. Girls recognised how being active was impacted by the challenges and opportunities in their local community (e.g., lack of facilities and anti-social behaviour).

CONCLUSION

This study provides insight into low-SEP pre-teen girls' experiences of being physically active in both rural and urban locations, while highlighting the complex interplay of individual, social and environmental factors. Additionally, the use of the TDF presents an in-depth behavioural diagnosis which can be used to inform future theory-based interventions to promote low-SEP pre-teen girls PA.

Trends in Nutrition-Related Risk Factors Identified Post-Operatively in Patients Treated for a Lower-Extremity Injury

This study investigated trends within a custom Sports Nutrition Assessment for Consultation (SNAC) survey designed to identify nutrition-related risk factors among post-operative lower-extremity youth athletes. Athletes aged 8-18 years who completed the SNAC at a sports medicine institution after lower-extremity surgery were reviewed for associations between SNAC questions and age/sex differences. Of 477 patients (15.0 ± 2.0 years; 47.8% female), 319 (66.9%) answered 'yes' to at least one question and were identified for a consult, though 216 (64.3%) declined. The most frequent questions to prompt a consult were a desire to better understand nutrition for recovery (41.5%) and regularly skipping at least one meal a day (29.8%). Inter-question responses were often significantly related, especially regarding appetite changes, weight changes, and/or meal-skipping. While consult acceptance was not significantly different between sex/age, males were more likely to report a desire to better understand nutrition (p = 0.004) and a weight change (p = 0.019), and females were more likely to report struggling with dizziness/fatigue (p < 0.001). Additionally, older athletes reported an appetite change (p = 0.022), meal-skipping (p = 0.002), a desire to better understand nutrition (p < 0.001), a weight change (p < 0.001), and an effort/recommendation to change their body composition/weight (p = 0.005). These findings demonstrate a link between risky nutrition behaviors and physical detriments.

"It's what mothers do." A qualitative exploration of mothers' experiences of supporting their daughter to be physically active

OBJECTIVE

Girls are more at risk than boys of the non-communicable diseases associated with insufficient levels of physical activity (PA), therefore it is important to explore the reasons why girls maintain or cease to be physically active. Maternal support plays an important role in girl's PA, yet the factors influencing mothers' support of their PA have received limited exploration. In response, the aim of this study was to explore, mothers' experiences of supporting their daughters to be physically active and their perceptions of the factors that might influence these experiences.

METHOD

Semi-structured interviews were conducted with a purposive sample of mothers (n = 29) of girls (Mean age = 10.9 years; SD = 0.6). Reflexive Thematic Analysis was used to analyse the data, with themes mapped to the relevant domains of the Theoretical Domains Framework.

RESULTS

Themes highlighted how mothers described providing PA support as an inherent part of their parental role and how their role was influenced by their own PA identity. Mothers recognised that the type and amount of support they provided was impacted by the community setting in which they lived. Mothers acknowledged how the role of others (e.g., partners, grandparents, peers) added a layer of complexity to supporting their daughters to be active.

CONCLUSION

This study advances our understanding of maternal PA support behaviours recognising the complex interplay of individual, social and environmental factors. Additionally, the use of the Theoretical Domains Framework presents an in-depth behavioural diagnosis which can be used to inform future theory-based interventions to promote parent support of children's PA.

Cognitive CAMSA: an ecological proposal to integrate cognitive performance into motor competence assessment

Purpose

To profile the participants using a system of self-organizing maps (SOM) based on their motor and cognitive performance during a dual-task version of the Canadian Agility and Movement Skill Assessment (Cognitive CAMSA).

Methods

A total of 169 secondary school students (39.3% girls) volunteered to participate. The original CAMSA, cognitive CAMSA, the Corsi and Digit Span tests were used to assess (a) motor competence, (b) motor competence with cognitive load, and (c) cognitive performance, respectively. SOMs and the k-means clustering algorithm were used to establish the adolescents' dual-task performance profiles.

Results

Including decision making based on verbal and visual cues in the original CAMSA significantly increased the participants' total scores but also the time required to complete the test, while the skill score remained unchanged. However, not all the participants showed changes in their performance in the same direction during the cognitive CAMSA. Person-centered analyses by SOMs and k-means clustering identified six performance profiles with variations in the cognitive, motor skill, and time scores (H5 = 146.15, H5 = 102.68, and H5 = 108.07, respectively; all p < 0.01).

Conclusion

The cognitive CAMSA was shown to be a feasible field-motor test for assessing motor competence with a cognitive load in an ecological setting. Some of the profiles identified in the SOM approach represented adolescents with similar motor and cognitive performance in dual-task or single-task contexts, although other participants obtained high motor competence in single and dual-tasking while their cognitive performance declined or rose more in dual-task than in single task situations. The cognitive CAMSA emerges as a tool of great potential, applicable in educational and sports environments, to know subjects' characteristics and try to individualize the interventions accordingly with their dual-task profile.

Body Mass Index Trends before and during the COVID-19 Pandemic in Primary School Students in Split-Dalmatia County, Croatia: A Retrospective Study

Within the last decade, childhood obesity has become a serious problem, especially during the COVID-19 pandemic. This research paper aimed to examine whether body mass index (BMI) was higher during the pandemic (2020-2022) than in the pre-pandemic period (2012/2013-2019) using trends related to sex, urban-rural area, and physical activity (PA). This study included data from physical examinations of an entire population of primary school children from Split-Dalmatia County (Croatia) over a period of 10 years. There were 103,804 students from the first, fifth, and eighth grades who participated in the analysis. During the pandemic, the BMI of all the students increased, except for eighth-grade girls. Generations of eighth graders have had significantly different BMIs throughout the past decade. We found that first graders were overweight and obese in urban areas, while in rural areas, this problem was experienced by upper grades. Girls were more overweight and obese in the first and eighth grades, but boys experienced this more in the fifth grade. Reduced PA influenced an increase in BMI in both sexes, especially in girls. During the pandemic, this situation became worse. This study could be useful to experts for the creation of new policies for Split-Dalmatia County and surrounding regions that are similar economically and culturally.

Influence of physical fitness components on personality factors and risk perception of children and adolescents: a cross-sectional study

OBJECTIVES

To examine the associations of cardiorespiratory fitness (VO2 max) and muscular strength with indicators related to the risk scale, such as perceived competence, sensation seeking, competitiveness, risk taking and risk perception in sports.

DESIGN

Cross-sectional study.

SETTING

High schools from the Region of Murcia (Spain).

PARTICIPANTS

Three-hundred-and-seventeen adolescents participated (mean age: 13.69±1.2 years old).

PRIMARY AND SECONDARY OUTCOME MEASURES

Body mass, body height, Course-Navette test, upper limb strength and psychoeducational factors that determine the propensity towards sports accidents in school children, the Sports Accident Propensity Scale were evaluated. It was performance t-test for independent samples, stepwise multiple linear regression models and a multiple mediation analysis.

RESULTS

The analysis showed significant differences with respect to sex in height, VO2 max, handgrip strength and in all factors of the questionnaire (p=0.02-<0.01). Adolescents who presented greater VO2 max, strength in the handgrip test and age showed a higher score in factors 1 and 3. Higher scores in factor 2 were associated with better VO2 max and strength in handgrip test. Youngers and better values of strength in the handgrip showed higher score in factors 4 and 5. The mediation analysis with two mediating variables (handgrip strength and VO2 max) showed a significant indirect effect. When handgrip strength and VO2 max were included in the equations, the association between sex and each factor ceased to be significant.

CONCLUSION

This study highlights the potential benefits of muscular strength (handgrip) and VO2 max in the perceived risk scale, and the variable of age on this.

TRIAL REGISTRATION NUMBER

Clinical trial: NCT05544370 (pre-results).

What are the correlates of intention to be physically active in Brazilian adolescents? A network analysis

OBJECTIVE

The current study aimed to explore the association of individual characteristics, social and environmental factors - school and region - in the intention to be physically active in Brazilian adolescents.

METHODS

This is a cross sectional study based on the third edition of the National School Health Survey. The study included a total of 53,937 adolescents. To assess the intention to be physically active, only who engaged in less than 300 min of physical activity per week were included. Participants were asked: "If you had the opportunity to practice physical activity most days of the week, what would your attitude be?" Individual characteristics, physical activity domains, social factors, school, and regional environments were used as exposures. Network analysis was utilized to evaluate the associations.

RESULTS

We observed that boys had higher intentions to be physically active compared to their peers, as did adolescents who perceived themselves as fat. In addition, students from private schools show a higher intention to regularly engage in physical activities, and in general, private schools offer more extracurricular physical activities.

CONCLUSION

In conclusion, individual factors such as sex and body image perception, and environmental factors such as school administrative dependency and availability of extracurricular activities had a significant contribution to the intention to be physically active among Brazilian adolescents.

The Effect of Social Networks on Active Living in Adolescents: Qualitative Focus Group Study

BACKGROUND

Participation in organized sports and other forms of active living have important health benefits in adolescence and adulthood. Unfortunately, the transition to secondary school has been shown to be a barrier to participation. Social networks can play important roles in activating adolescents, and information and communication technology (ICT) interventions can augment this role. To date, there are few insights into what adolescents themselves think and feel about barriers to and motivators for active living, the role of their social networks in active living, and the potential of ICT for physical activity (PA).

OBJECTIVE

This study aimed to gather insights into the perspectives of adolescents aged 12 to 14 years on active living and sports participation, motivators and demotivators for active living, and the potential roles of their social network and of ICT.

METHODS

A total of 26 adolescents aged 12 to 14 years from different levels of Dutch secondary schools participated in 1 of 5 semistructured focus group interviews, in which they talked about sports and PA, their social networks, their ICT use, and the role of social networks and ICT in PA. All interviews were transcribed and analyzed using a thematic qualitative approach.

RESULTS

The study showed that all participants were physically active, although the transition to secondary school made this difficult, mostly because of time constraints. Participants saw positive physical and mental health effects as important benefits of active living. They regarded social benefits as strong motivators for active living: being together, making friends, and having fun together. However, the social network could also demotivate through negative peer judgment and negative feedback. Participants were willing to share their own positive experiences and hear about those from close peers and friends but would not share their own (and were not interested in others') negative experiences or personal information. Participants were mainly interested in descriptive norms set by others and obtained inspiration from others for PA. With respect to using ICT for active living, participants stated a preference for social challenges among friends, personalized feedback, goals, activities, and rewards. Competition was seen as less important or even unattractive. If mentioned, participants felt that this should be with friends, or peers of a similar level, with fun being more important than the competition itself.

CONCLUSIONS

This study shows that adolescents feel that their social network is and can be a strong driver of active living. They are willing to use ICT-based solutions that make use of social networks for PA as long as these solutions involve their current (close) network and use an approach based on being together and having fun together.

Sustaining youth physical activity in times of challenge and change: lessons from COVID-19

Physical activity (PA) is recognized as essential for positive physical and mental well-being in young people. However, participation in PA is known to decline as adolescents emerge into adulthood under the influence of complex social and structural factors. Globally, COVID-19 restrictions resulted in changes to PA and PA participation levels in youth populations, providing a unique opportunity for gaining insight into PA barriers and enablers in circumstances of challenge, limitation and change. This article details young people's self-reported PA behaviours during the 4-week 2020 COVID-19 lockdown in New Zealand. Taking a strengths-based view and drawing on the COM-B (capabilities, opportunity and motivation behaviour) model for behaviour change, the study explores factors enabling young people to sustain or increase PA during lockdown. Findings are drawn from qualitative-dominant mixed-methods analyses of responses to an online questionnaire: New Zealand Youth Voices Matter (16-24 years; N = 2014). Key insights included the importance of habit and routine, time and flexibility, social connections, incidental exercise and awareness of links between PA and well-being. Of note were the positive attitudes, creativity and resiliency demonstrated as young people substituted or invented alternatives to their usual PA. PA needs to change to adapt to new circumstances over the life course, and youth understanding and knowledge of modifiable factors may provide support for this. Thus these findings have implications for sustaining PA during late adolescence and emerging adulthood, a life phase that can be associated with significant challenge and change.

Sex and educational level differences in physical activity and motivations to exercise among Spanish children and adolescents

Children and adolescents worldwide, especially girls, do not meet moderate to vigorous physical activity (MVPA) guidelines, a situation which is related to obesity and other comorbidities. Sex/gender differences in the practice of MVPA and motivations to engage in physical activity have not been previously examined among Spanish students considering different educational levels. Therefore, the purpose of this study was to explore these differences and analyse if motivations mediate the relationship between educational levels and MVPA in a large sample of students. From different schools in the Madrid region (primary: 11,122; lower secondary: 12,379; upper secondary: 3228) 26,729 students (13,491 boys and 13,238 girls; 9-19 years old) were recruited to participate in this study. The short form of the International Physical Activity Questionnaire and the third version of the Behavioural Regulation in Exercise Questionnaire were used to evaluate, MVPA and motivations to exercise, respectively. Two-way ANCOVA and a mediation analysis were performed. Female students were found to be less active than males (43.4±38.7 and 58.6±45.9 min of MVPA; p < 0.001; η_p² = 0.023) and showed lower intrinsic (η_p² = 0.003), and integrated (η_p² = 0.007) motivations than their male counterparts (p < 0.001). Primary school students were more active than lower and upper secondary students (53.3±44.2, 49.9±42.3 and 48.0±42.8 min of MVPA; p < 0.001; η_p² = 0.002) and also presented higher intrinsic (η_p² = 0.011) and integrated (η_p² = 0.010) motivation than secondary school students (p < 0.001).    Conclusion:   Among Spanish children and adolescents, females showed lower levels of MVPA and intrinsic and integrated motivation across all the educational levels, and among primary school students in comparison to secondary school. This suggests that inner motivation is more determinant of increased engagement in MVPA and thus, there is need to reinforce it before the transition to secondary school and with special focus on females' preferences. What is Known: •Many children and adolescents worldwide, do not meet physical activity (PA) recommendations. • Within the self-determination theory, autonomous motivation seems to be the main responsible of greater PA levels. What is New: •This study shows for the first time sex and educational level differences in PA levels in a representative sample of Spanish students (9-19 yrs). •Autonomous motivation decreased from primary school onwards and was lower in female students than in their male counterparts.

ASPHALT II: Study Protocol for a Multi-Method Evaluation of a Comprehensive Peer-Led Youth Community Sport Programme Implemented in Low Resource Neighbourhoods

To reduce inequalities in children's sport participation, studies are needed to explore ways in which children from low resource neighbourhoods can be engaged and retained in sport. GAME Community is a peer-led community sport programme which aims to promote physical activity through participation in inclusive street sports activities targeting 8-15-year-old children living in low resource neighbourhoods. The GAME Community intervention is implemented by the non-profit street sport organisation GAME. Five components support the implementation of GAME Community: (1) training of peer leaders; (2) a focus on inclusion of inactive girls; (3) parental involvement; (4) community engagement; (5) strengthened organisational support to peer leaders. In the ASPHALT II study, we aim to evaluate GAME Community and hence contribute to understanding how children growing up in low resource neighbourhoods can be engaged and retained in physical activity through participation in peer-led, community-based sport and to generate new understandings on the scale up of community interventions. The primary objective of the evaluation is to investigate the implementation of GAME Community and the programme's reach, and to establish the functioning and mechanisms of the programme. The secondary objective is to establish the health enhancing potential of the programme. The evaluation of GAME Community involves three linked but independent studies that investigate (1) the functioning (i.e., mechanisms and processes), (2) reach, and (3) outcomes. The functioning of the five intervention components is investigated using qualitative methodologies. Programme reach will be investigated based on participant registrations. Systematic observations using a novel combination of validated tools will provide information on outcomes (physical activity level and social behaviour) during GAME Community activities. Investigating functioning, reach, and outcomes of the GAME Community intervention by using multiple methods is a strength, as different data complement and inform each other. This study will provide in-depth insights into if and how children living in low resource neighbourhoods can be engaged and retained in physical activity through participation in peer-led, community-based sport. Contributions of this evaluation include new understanding of the mechanisms and scalability of a community-based street sport intervention.

Adolescents’ Perceived Barriers to Physical Activity during the COVID-19 Pandemic

During the COVID-19 pandemic, adolescents’ routines were deeply affected, which negatively impacted their level of PA. Knowing the barriers to PA in adolescence is relevant, because the perception of more barriers is one of the most consistent negative correlates of PA participation. The purpose of this study was to analyze and compare the barriers perceived by adolescents during the COVID-19 pandemic by sex, education level, PA level, and BMI. A total of 1369 students (621 boys and 748 girls; mean age: 14.4 years; SD: 1.74) participated in the study. The chi-square test was used to analyze the differences between groups. Only 3.1% of the adolescents complied with the international guidelines for PA. In general, the barriers with the highest prevalence were the COVID-19 pandemic, lack of time, and taking time away from study. The number of perceived barriers to PA was higher among girls, younger, and inactive participants. Boys selected more the barriers due to COVID-19 than girls, and students with normal weight chose more barriers than those with overweight. This study provides information on adolescents’ PA barriers during the COVID-19 pandemic and draws attention to the negative effects that restrictive measures have had on adolescents’ PA levels.

The Barriers to and Facilitators of Physical Activity and Sport for Oceania with Non-European, Non-Asian (ONENA) Ancestry Children and Adolescents: A Mixed Studies Systematic Review

BACKGROUND

Participation in sport and physical activity (PA) leads to better overall health, increased life expectancy, and decreased mortality rates across the lifespan; however, there may be a range of individual, family, and community factors that influence PA participation among ONENA children and adolescents residing in the 22 Pacific Island Countries and Territories (PICT) and Australia. This review aimed to synthesise existing quantitative and qualitative literature regarding barriers to and facilitators of PA and sport among ONENA youth.

METHODS

The literature was systematically searched to include studies reporting barriers to and facilitators of PA and sports participation among ONENA children and adolescents aged 0-18 years residing in the 22 PICT and Australia. Using a pre-established taxonomy based on the social-ecological model, a deductive analysis was performed. Quality appraisal was performed using the mixed methods appraisal tool.

RESULTS

Of 1388 articles, 14 studies were included, with 128 ONENA children and adolescent participants across the four qualitative studies; 156,581 ONENA children and adolescents across the seven quantitative studies; 801 parents, children, and adolescents in one quantitative study; and 642 parents in two quantitative studies. Of the 14 included studies, none were based in Australia and only 10 of the 22 PICT were reported as the participants' residence: Palau, New Zealand, Tonga, Cook Islands, Kiribati, Samoa, Solomon Islands, Tuvalu, Vanuatu, and Fiji. Four studies reported barriers, and another four studies reported facilitators of PA and sport, with the remaining studies reporting both barriers and facilitators. Overall, there were more barriers reported (30 in total) than facilitators (27 in total).

CONCLUSIONS

Research in this area is lacking, with ONENA youth living in Australia and 12 PICT not represented. Overall, there were a larger number of facilitators experienced at individual and interpersonal levels, while barriers were highest at the community level, with the policy level having facilitators and barriers equally represented. Programs that offer PA and sport participation options with embedded SDT-informed strategies for all family members; that are accessible through existing transport and related social, cultural, and physical infrastructure; and that are committed to communities through formal co-design partnerships are needed, to enhance the PA and sport participation of ONENA youth residing in PICT.

Feasibility of a peer-led, after-school physical activity intervention for disadvantaged adolescent females during the COVID-19 pandemic: results from the Girls Active Project (GAP)

Introduction

There is a critical need for interventions that can be feasibly implemented and are effective in successfully engaging adolescent females in physical activity (PA). A theory-based, peer-led, after-school PA intervention, the Girls Active Project (GAP), was codesigned with adolescent females. This study aimed to assess the feasibility of implementing and evaluating the GAP programme.

Setting

One single-sex, female-only, designated disadvantaged postprimary school (students aged 12–18) in Dublin, Ireland.

Methods

Mixed methods were applied with multiple stakeholders over a 12-week trial (March to May 2021). A single-arm study design was used to examine intervention: reach, dose, fidelity, acceptability, compatibility and context. Feasibility of using proposed self-reported outcome measures (moderate-to-vigorous PA levels, self-rated health, life satisfaction, PA self-efficacy and PA enjoyment) was also explored. Due to school closure resulting from the COVID-19 pandemic, the intervention was delivered both online and in person in the school setting.

Results

Eight exercise classes were peer delivered by project leaders (n = 6, students aged 15–17) to intervention recipients (students aged 13-14). Recruitment was low (n = 8, 10% of eligible students, mean age: 13.3 SD: 0.46), yet retention was high (n = 7/8, 88%). Attendance rates were satisfactory (68%), and the intervention was implemented with high fidelity (87%). Data completion rates suggested proposed self-reported outcome measures were deemed appropriate (≥ 95%), except for weight (50%) and height data (80%). Despite COVID-19 hindering intervention implementation, both quantitative and qualitative data suggested that stakeholders were satisfied and perceived the in-person delivered intervention to be compatible with the school setting. Recommended refinements included extending class duration, introducing different rewards, and boosting programme awareness.

Conclusions

Further thought must be given on how to increase recruitment. Overall, the in-person delivered after-school PA programme was well-received by stakeholders and shows promise as an intervention that can be feasibly implemented and evaluated. Suggested improvements to the GAP intervention programme are recommended, before continuing to a more robust evaluation.

Trial registration

10.17605/OSF.IO/75HWJ (prospectively registered, date of registration: 9th December 2020)

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01149-2.

Prevalence of meeting 24-Hour Movement Guidelines from pre-school to adolescence: A systematic review and meta-analysis including 387,437 participants and 23 countries

BACKGROUND

Meeting the 24-Hour Movement Guidelines (physical activity, screen time, and sleep duration) has been associated with positive health indicators. However, there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world. Therefore, the main purpose of this systematic review and meta-analysis was to examine the overall (non)adherence to the 24-Hour Movement Guidelines among preschoolers, children, and adolescents worldwide.

METHODS

Four electronic databases (MEDLINE, Scopus, Web of Science, and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021. Studies that were conducted with apparently healthy participants and reported the overall (non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.

RESULTS

Sixty-three studies comprising 387,437 individuals (51% girls) aged 3-18 years from 23 countries were included. Overall, 7.12% (95% confidence interval (95%CI): 6.45%-7.78%) of youth met all three 24-Hour Movement Guidelines, and 19.21% (95%CI: 16.73%-21.69%) met none of the 3 recommendations. Concerning sex, adherence to all recommendations was significantly lower in girls (3.75%, 95%CI: 3.23%-4.27%) than in boys (6.89%, 95%CI: 5.89%-7.89%) (p < 0.001). However, there were no sex differences regarding adherence to any of the 3 individual recommendations (girls, 15.66%, 95%CI: 8.40%-22.92%; boys, 12.95%, 95%CI: 6.57%-19.33%). In terms of age group, adherence to the 3 recommendations was 11.26% (95%CI: 8.68%-13.84%), 10.31% (95%CI: 7.49%-13.12%), and 2.68% (95%CI: 1.78%-3.58%) in preschoolers, children, and adolescents, respectively. Conversely, 8.81% (95%CI: 5.97%-11.64%) of preschoolers, 15.57% (95%CI: 11.60%-19.54%) of children, and 28.59% (95%CI: 22.42%-34.75%) of adolescents did not meet any of the recommendations. South America was the region with the lowest adherence (all: 2.93%; none: 31.72%). Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index (β = -0.37, 95%CI: -0.65 to -0.09; p = 0.010).

CONCLUSION

Most young people fail to meet the three 24-Hour Movement Guidelines, particularly adolescents, girls, and those who are from countries with a lower Human Development Index. Moreover, 1 in 5 young people did not meet any of these recommendations. Therefore, these results highlight the need to develop age- and sex-specific strategies to promote these movement behaviors from the early stages of life.

Changes in subdomains of non-organized physical activity between childhood and adolescence in Australia: a longitudinal study

BACKGROUND

Physical activity (PA) participation among youth tends to be insufficient and is prone to decline with age. In Australia, this decline has been shown to particularly occur in the domain of non-organized PA (e.g. active play and informal sport) between childhood and adolescence. However, information about changes in more specific groupings of activities within non-organized PA (i.e. subdomains) is needed, as this could support more targeted intervention strategies. This study aimed to investigate changes in the duration of specific subdomains of non-organized PA between late childhood (10-11 years) and early adolescence (12-13 years) in Australia, as well as whether these changes are moderated by sex.

METHODS

Data were sourced from Waves 6 and 7 of the Longitudinal Study of Australian Children (n = 3614). Youth time-use diaries (24-h) were used to measure the duration of eight subdomains of non-organized PA at both waves (athletics/gymnastics, ball sports, cycling/motor/roller sports, fitness/gym/exercise, martial arts/dancing, water/ice/snow sports, active play and other outdoor/nature PA). Multilevel mixed modelling was used to explore longitudinal changes between waves and the potential moderation effect of sex.

RESULTS

Active play declined the most of all subdomains (β = -20.5 min/day; 95% CI = -23.4, -17.6, p < 0.001). A smaller decline was observed in the subdomain of non-organized ball sports (β = -4.1 min/day; 95% CI = -5.9, -2.3, p < 0.001). Other subdomains remained stable or had only very small changes in participation. The decline in active play was moderated by sex, with a steeper decline among girls. No other notable moderation effects were observed.

CONCLUSIONS

Future studies may seek to explore and test the acceptability of PA promotion strategies to encourage active play participation, such as 'reframing' childhood play activities to be appropriate for adolescents. Such studies might particularly seek the perspectives of girls in the transition to adolescence.

Barriers to Physical Activity in Spanish Children and Adolescents: Sex and Educational Stage Differences

According to worrisome childhood obesity and inadequate physical activity (PA) levels worldwide, especially exacerbated in adolescents girls, this work aimed to identify sex and educational stage differences in barriers to meet PA requirements and international guidelines in Spanish children and adolescents considering the entire educational pathway (primary, secondary, and college). The Short Form of the International PA Questionnaire and the Scale of Perceived Barriers were administered to primary, secondary, and college education students (13,491 boys and 13,238 girls, 9–19 yrs). Two-way ANOVA was performed to analyze barriers to PA according to sex and educational stage with physical status as covariate. Higher disliking and time barriers were reported by females (1.5 ± 1.2 and 3.2 ± 1.5 points) in comparison to males (1.2 ± 1.0 and 2.8 ± 1.4), while primary students showed lower disliking and time (1.2 ± 1.0 and 2.8 ± 1.5) and higher safety (3.1 ± 1.8) constraints in comparison to secondary (1.4 ± 1.1, 3.1 ± 1.4, and 2.8 ± 1.7) and college (1.5 ± 1.2, 3.2 ± 1.5, and 2.8 ± 1.6; p < 0.05 for all comparisons). College females showed higher disliking (1.7 ± 1.2) and time (3.5 ± 1.4) barriers than secondary females (1.5 ± 1.2 and 3.3 ± 1.4; p < 0.05). Sex and educational stage were determinant for time and dislike of PA barriers, which were rated higher by female students in comparison to their male counterparts and from primary education onwards. Altogether this, suggests promotion strategies should carefully consider girls and the step into secondary school.

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.

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

Background

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

Methods

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

Results

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

Conclusions

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

Barriers and Facilitators of Physical Activity Participation in Adolescent Girls: A Systematic Review of Systematic Reviews

Background: Persistent low physical activity (PA) levels among adolescent girls constitute a public health concern that calls for immediate and evidence-based policy action. This systematic review (SR) aimed to summarize evidence from SRs examining the barriers and facilitators of PA participation in adolescent girls. The objectives were to provide a synthesis of the available evidence and identify key areas for fostering gender-responsive action and policy implications. Methods: A comprehensive search of relevant SR and meta-analyses were performed in PubMed and Cochrane Library, until February 2021. Studies were included if they were SRs or meta-analyses, included adolescent girls aged between 10 and 19 years, and described barriers or facilitators of PA. Two independent authors performed the screening of potentially eligible studies and both assessed the methodological quality of included studies using the AMSTAR 2 tool. The barriers and facilitators were synthesized at environmental, interpersonal, and individual levels. Results: A total of eight SRs were included in the qualitative synthesis. The most frequent barriers identified were the lack of support from peers, family, and teachers, and the lack of time. The most reported facilitators were weight loss, and support from peers, family, and teachers. Key areas for action and policy implementation include an inclusive approach to curriculum development to address gender norms; adequate training of professionals so they have a range of skills to ensure inclusion of adolescent girls; environmental changes in and out of schools to stimulate participation, to allow adolescent girls to be active in a safe and attractive environment; multistakeholder support at local, regional, and national level in incorporating a gender-responsive approach toward PA participation. Conclusion: The results highlight a variety of factors that influences the PA participation of adolescent girls. For the attainment of effective policies that increase PA levels in adolescent girls, it is essential to engage several stakeholders at different levels in incorporating a gender-responsive approach toward PA participation. Systematic Review Registration: PROSPERO, identifier: CRD42020204023.

The Role of Physical Activity in the Relationship between Satisfaction with Life and Health-Related Quality of Life in School-Age Adolescents

(1) Background: Adolescence is a critical stage in the development of healthy habits. In this regard, physical activity has emerged as a useful tool to improve satisfaction with life and health-related quality of life in adolescents. Therefore, the aim of the present study was to examine the mediating role of physical activity in the relationship between satisfaction with life and health-related quality of life in adolescent boys and girls. Also, we aimed to investigate the differences between sexes in the HRQoL, physical activity level, and satisfaction with life. (2) Methods: A total of 297 adolescents, ranging in age from 11 to 12 years (11.46 ± 1.63), participated in this cross-sectional study. The Satisfaction with life scale, Physical activity Questionnaire for Adolescents and the KIDSCREEN-10 questionnaires were employed. (3) Results: The estimated indirect effect showed that physical activity level was a mediator of the positive effect of satisfaction with life on health-related quality of life (β = 0.105, 95% CI = 0.031; 0.202). However, the index of moderated mediation showed that sex is not a significant moderator of the mediating role of physical activity in the relationship between satisfaction with life and HRQoL (β = -0.033, 95% CI = -0.023, 0.136). Furthermore, significant differences in satisfaction with life were found, with girls manifesting lower values (p-value = 0.026). (4) Conclusion: This study shows the importance of physical activity during adolescence and the association of this behavior with the health-related quality of life of adolescents.

Unequal physical activity among children with cerebral palsy in Sweden-A national registry study

AIM

To examine the extent to which sex, country of birth, and functional aspects influence participation in physical education and physical leisure activity among children with cerebral palsy (CP) in Sweden.

METHODS

This national cross-sectional registry study included children with CP aged 6 to 18 years who participated in the Swedish national quality registry, the Cerebral Palsy Follow-up Program, CPUP, in 2015. Comparisons and associations between sex, country of birth, and functional aspects and physical leisure/physical education were examined using chi-squared and multivariable logistic regression analysis.

RESULTS

The study included 1935 children. Of them, 1625 (87%) reported participating in physical education and 989 (53%) reported participating in physical leisure activity. Children born in Sweden had higher odds of participating in physical education (OR: 1.99; 95% CI: 1.20-3.28) and physical leisure activity (OR: 2.51; 95% CI: 1.70-3.72) compared with children born outside Europe. Greater impairment of gross motor function was associated with lower participation levels. Boys participated slightly more frequently in leisure activities than girls.

CONCLUSION

Enhancing social inclusion with regard to disability, birth country, and sex are important and achievable goals for policymakers and practitioners for promoting participation in physical activity for children and adolescents with CP.

Seasonal changes in the physical activity levels of youth Gaelic football players

This study quantified changes in physical activity (PA) levels attained by adolescents during Gaelic football (GF) participation across two time points in a season and determined if these changes affected their overall daily PA levels. A total of 130 adolescents (65 females;15.3 ± 1.5 years) wore an activPAL accelerometer to determine total moderate PA (MPA), vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) during a seven-day measurement period, including during GF. The PA measurement was completed at "preseason" (T1) and "in-season" (T2) timepoints. Between T1 and T2, females significantly increased time spent in MVPA daily (p < 0.001, d = 0.95), on Gaelic football days (GFDs) (p = 0.036; d = 0.30), on non-Gaelic football days (NGFDs) (p < 0.001; d = 0.43), and during GF (p < 0.001, d = 0.90). Males did not record any significant changes in PA over time (p > 0.05). At T2, there were no significant differences in time spent in MVPA daily, on GFDs and NGFDs, and during GF between the genders (p > 0.05). The results suggest that the change in daily PA levels by females is a consequence of increased MVPA during GF and reduced PA barriers across the season.

Teachers' perspectives on the barriers to healthy lifestyle behaviors among adolescent girls of disadvantaged backgrounds in Ireland: A qualitative study

Though adolescence is a particularly sensitive period regarding the development of long-lasting health-related attitudes and behaviors, little research has examined the factors which influence their engagement in such behaviors. Adolescent females are particularly sensitive to suffer from overweight and obesity. It is also a time that can impact the health patterns of future generations due to the influence of preconception maternal factors on the health of their offspring. Furthermore, much research has identified a strong socioeconomic gradient in obesity in Ireland, with individuals from low socioeconomic backgrounds being particularly likely to develop unhealthy habits. The current study aimed to develop an understanding of the factors which influence the health-related behaviors of adolescent girls of low-socioeconomic status in Ireland, an underrepresented yet particularly sensitive cohort. Semi-structured interviews were conducted with nine teachers from disadvantaged schools in Dublin and were examined using a thematic analytic approach. Nine themes were identified: lack of interest and knowledge, lack of self-confidence, the dual role of modern technology, behaviors of significant others, need for good role models, availability of convenience foods, inadequate existing approaches and initiatives, lack of resources to promote a healthy lifestyle, and living difficulties at home and in the community. Findings suggested ways for intervening at personal, interpersonal, organizational and community levels. In conclusion, a range of practical changes are required in the home, school, and community environments in order to improve the health of these individuals, and ultimately to improve the health of future generations.

Physical Activity and Quality of Life in High School Students: Proposals for Improving the Self-Concept in Physical Education

Adolescence is a critical period for the acquisition of health-related behaviors that will transcend later psychological well-being in adulthood. The present study presents a theoretical model whose objective is to analyze how physical activity predicts an adequate quality of life through self-concept and subjective happiness among adolescents. A total of 452 students aged 12 to 15 (M = 13.8; SD = 0.77) from four Compulsory Secondary Education institutes of the Autonomous Community of Extremadura participated, including boys (n = 258) and girls (n = 194). The students reported information on the following variables: physical activity, body mass index, self-concept, subjective happiness, and quality of life. The results show acceptable fit indices for the proposed theoretical model, which showed the importance of physical activity through self-concept and subjective happiness in quality of life: MRLχ2 = 67.533, p < 0.05, CFI = 0.93, TLI = 0.90, SRMR = 0.05, and RMSA = 0.07. Likewise, the model presented a better fit index for males than females. This study draws conclusions on the importance of physical activity as a predictor of quality of life mediated by the perception of self-concept and mood in adolescents.

Adolescents' Perspectives on the Barriers and Facilitators of Physical Activity: An Updated Systematic Review of Qualitative Studies

Listening to adolescents' voices has been important to promote meaningful physical activity (PA) opportunities. Therefore, an updated systematic review of the available qualitative literature on adolescents' perspectives on the barriers and facilitators of PA was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published between 2014 (date of the last systematic review) and 2020 were searched in the Web of Science, EBSCO, and SCOPUS databases. Based on the inclusion criteria applied, 30 out of 8069 studies were included in the review. A thematic analysis was used to inductively and deductively analyze the perspectives of ~1250 adolescents (13-18 years). The studies took place in 13 countries from different continents. The main PA barriers and facilitators of PA were presented and discussed around five higher-order themes: (1) Individual factors (e.g., psychological-motivation, self-efficacy; cognitive-knowledge, understanding; physical-motor skills); (2) social and relational factors (family, friends, significant others); (3) PA nature factors (fun, school-based PA and physical education); (4) life factors (time and competing activities; life-course); and (5) sociocultural and environmental factors (e.g., availability/access to PA facilities, programs; urban/rural zones). By transnationally framing adolescents' voices, this study provides updated evidence and discusses innovative implications for developing tailored interventions and pedagogical strategies aimed at promoting active and healthy lifestyles.

Factors influencing obesogenic behaviours of adolescent girls and women in low- and middle-income countries: A qualitative evidence synthesis

This systematic review synthesized the qualitative evidence on factors influencing obesogenic behaviours in adolescent girls and women of reproductive age in low- and middle-income countries (LMICs). This qualitative evidence synthesis followed the framework synthesis approach to extract, analyse and synthesize data. Electronic searches were conducted in the Web of Science, SCOPUS, CABI Abstracts, MEDLINE, PsycINFO and Google Scholar. Studies were eligible if they were conducted in LMICs, of qualitative nature, and reported obesogenic behaviours of female adolescents (10-19 years of age) or women of reproductive age (15-49 years of age). The review resulted in 71 included studies from 27 different countries. Thirty-two studies focused on dietary behaviours, 17 on physical activity and 22 on both behaviours. Gender norms and failures to recognize the importance of healthy behaviours across the life cycle were important factors. The abundance and promotion of affordable but unhealthy food, food safety concerns, taste preferences and social desirability of foods drive consumption of unhealthy foods. Busy lives and limited exercise spaces keep girls and women from being physically active. Obesogenic behaviours of adolescent girls and women of reproductive age are influenced by factors at individual, social, physical and environmental levels and require diverse solutions to address these factors in LMICs.

A School-Level Examination of the Association between Programs and Policies and Physical Activity Outcomes among Females from the COMPASS Study

(1) The majority of Canadian youth are not meeting physical activity guidelines, and more female than male youth are falling short of these recommendations. School programs and policies are a viable strategy to improve youth physical activity. However, they may differentially affect female and male activity. This study aimed to examine school-level differences in physical activity outcomes among male and female students and to explore how school programs and policies associate with school-level physical activity outcomes among females. (2) This study used data from 136 schools participating in year 7 (Y7 2018–2019) of the COMPASS study. Data on school programs and policies and on student physical activity were collected. School-level means and percentages for outcomes were calculated and compared between males and females and the impact of physical activity programs and policies on female physical activity outcomes were examined. (3) More males met the guidelines, achieved more strength training days and physical activity minutes compared to females. The number of female varsity sports, community partnerships and fitness ambassadors were all positively and significantly associated with female physical activity. (4) Supportive physical activity environments fostered by offering varsity sports, establishing community partnerships and positive role models may promote physical activity among female youth.

Relationship between Sedentary Time, Physical Activity, and Health-Related Quality of Life in Spanish Children

Higher sedentary time and lower physical activity (PA) are associated with a poor health-related quality of life (HRQoL) in children. The aims of this study were: (1) to analyze the sedentary time, objectively measured PA levels (light, moderate, vigorous, and moderate-to-vigorous physical activity (MVPA)), and HRQoL dimensions (physical well-being, emotional well-being, self-esteem, family, friends, school, and total score) in children; and (2) to examine the association between sedentary time, PA levels, and HRQoL in children separately by sex. A total of 459 children (8.4 ± 0.4 years old, 50.54% males) from 15 schools in Granada (Spain) participated in the study. A tri-axial accelerometer was used to measure PA levels in the children for 7 consecutive days. The Revidierter KINDer Lebensqualitätsfragebogen (KINDL-R) questionnaire was used to determine the children’s HRQoL dimensions. The results showed that males presented more minutes engaged in MVPA than females. Both sedentary time and PA levels were associated with self-esteem and total score (all p < 0.05). In males, moderate and vigorous PA levels were associated with higher HRQoL, whereas light PA was associated with higher HRQoL in females. Future studies should take into account the use of activities with difference intensities in order to increase HRQoL in males and females.

Formative Evaluation of a Home-Based Physical Activity Intervention for Adolescent Girls-The HERizon Project: A Randomised Controlled Trial

BACKGROUND

This is a formative evaluation study of the HERizon Project, a home-based multi-component physical activity (PA) intervention for adolescent girls in the UK and Ireland. Although not intended, this study coincided with the initial COVID-19 lockdown restrictions.

METHODS

A total of 42 female participants, aged 13 to 16 years old (mean = 14.2, SD = 1.1), were randomly allocated to: (i) the HERizon group (n = 22) or (ii) the wait-list control group (n = 20). Participants in the six-week HERizon group were asked to complete three PA sessions each week and engage in weekly behaviour change support video calls. The primary outcome measure was self-reported habitual PA. Secondary outcomes measures included cardiorespiratory fitness (20 m shuttle run), muscular strength (standing long jump), muscular endurance (push up test), and psychosocial outcomes (Perceived Competence Scale, Body Appreciation Scale, Self-Esteem Questionnaire, Behavioural Regulation in Exercise Questionnaire). Quantitative and qualitative process evaluation data were also collected. Outcome measures were assessed at baseline and after the six-week intervention.

RESULTS

There was no significant change in habitual PA between groups (LMM group*time interaction: p = 0.767). The HERizon group had significantly increased cardiorespiratory fitness (p = 0.001), muscular endurance (p = 0.022), intrinsic motivation (p = 0.037), and body appreciation (p < 0.003) in comparison to the wait-list control group. All participants in the intervention group completed the intervention and compliance to the intervention was high (participants completed 18 ± 2 sessions).

CONCLUSIONS

Although no change in PA was observed, HERizon resulted in improved physical fitness and psychosocial outcomes. These preliminary findings, alongside positive findings for feasibility and acceptability, highlight potential benefits from the home-based intervention, thus further investigation is warranted.

"Girls Aren't Meant to Exercise": Perceived Influences on Physical Activity among Adolescent Girls-The HERizon Project

Background. Adolescent girls are less active than boys, with approximately 10% of girls in Ireland and the United Kingdom meeting the minimum recommended daily physical activity (PA) guidelines. This study investigated factors perceived to influence PA among adolescent girls from low socioeconomic areas in order to inform the design of a future intervention (The HERizon Project). Methods. A total of 48 adolescent girls (13–18 years) from low socioeconomic areas of the United Kingdom and Ireland participated in focus groups (n = 8), to explore perspectives of physical activity and the influence of gender within this. Focus groups were thematically analyzed and interpreted within a socioecological framework. Results. Most girls enjoyed PA and were aware of its benefits. They identified both barriers and facilitators to PA at intrapersonal (fear of judgement and changing priorities WITH age), interpersonal (changing social pressures and support from others) and organizational (delivery of PE) levels. Gender inequality was a multilevel factor, crossing all socioecological levels. Conclusion. Although many adolescent girls enjoy PA, their experiences appear to be limited by a fear of judgement and an overarching sense of gender inequality. Future interventions, such as the HERizon Project, should address influences at intrapersonal, interpersonal and organizational levels to promote positive PA experiences for adolescent girls.

Youth Participatory Action Research for Health Equity: Increasing Youth Empowerment and Decreasing Physical Activity Access Inequities in Under-resourced Programs and Schools

To address gaps in the youth participation and adolescent physical activity (PA) promotion literature, we examined the feasibility of youth participatory action research (YPAR) in (a) general aftercare (YPAR only) and (b) with a physical activity intervention, (YPAR + PA) to reach marginalized youth and impact individual empowerment and second-order change for equitable PA access. We intervened during middle school, a developmental stage conducive to changing health habits. We used a concurrent, mixed-method triangulation design. Participants were students (94% non-Hispanic Black/African American, 75% free/reduced lunch) in the southeastern United States. YPAR was adapted from online modules. Youth conducted photovoice, capturing and analyzing social/environmental factors contributing to inequities in their schools/programs. PA inequities emerged for girls. Findings indicated feasibility of YPAR with systems supports. Changes occurred at the individual and systems level in the YPAR + PA program. Sociopolitical skills, participatory behavior, and perceived control empowerment subdomains increased pre-post, and youth qualitative responses aligned. A follow-up interview with the director revealed all youth-proposed changes occurred. A feedback loop was developed for continued youth input. Youth-led changes to increase PA access have potential to decrease health disparities by generating unique solutions likely missed when adults intervene alone.

Physical Activity, Sport and Physical Education in Northern Ireland School Children: A Cross-Sectional Study

Internationally, insufficient physical activity (PA) is a major health concern. Children in Northern Ireland (NI) are recorded as having the lowest levels of PA in the United Kingdom (UK). To date, validated and representative data on the PA levels of NI school children are limited. The aim of this study was to provide surveillance data on self-reported PA, sport and physical education (PE) participation of school children in NI. Differences between genders and factors associated with PA were also examined. A representative sample of primary (n = 446) and post-primary (n = 1508) children was surveyed in school using validated self-report measures. Findings suggest that PA levels are low, with a minority of children (13%) meeting the PA guidelines (primary pupils 20%, post-primary pupils 11%). NI school children have lower levels of PA, PE and sports participation than UK and European peers. A trend of age-related decline across all the domains of PA was apparent. The data presented highlighted that females are less likely to achieve PA guidelines, children from lower socio-economic background participate in school and community sport less often, and that enjoyment and social support are important variables in PA adherence. Policy solutions that would support implementation e.g., mandatory minimum PE time, whole school approaches to PA promotion and targeted investment in schools, particularly in areas of deprivation and for females, are suggested.

Recognition of 16-18-Year-Old Adolescents for Guiding Physical Activity Interventions: A Cross-Sectional Study

Adolescence is a rapid life stage requiring special attention wherein personal autonomy is developed to govern independent lifestyles. Unhealthy lifestyles are integral to prevailing adolescent physical inactivity patterns. Understudied 16-18-year-olds were investigated to establish physical activity prevalences and influencing health-related lifestyle factors. Adolescents were recruited randomly across 2017-2019 from Farnborough College of Technology and North Kent College, UK. Demographic and health-related lifestyle information were gathered anonymously and analysed using SAS® 9.4 software. Among the 414 adolescents included (48.3% male and 51.7% female), the mean (standard deviation (SD)) age was 16.9 (0.77). Approximately 15.2% smoked and 20.8% were overweight/obese. There were 54.8% perceiving themselves unfit and 33.3% spent >4 h/day on leisure-time screen-based activity. Around 80.4% failed to meet the recommended fruit/vegetable daily intake and 90.1% failed to satisfy UK National Physical Activity Guidelines, particularly females (p = 0.0202). Physical activity levels were significantly associated with gender, body mass index, smoking status, leisure sedentary screen-time, fruit/vegetable consumption and fitness perceptions. Those who were female, overweight/obese, non-smoking, having poor fitness perceptions, consuming low fruit/vegetables and engaging in excess screen-based sedentariness were the groups with lowest physical activity levels. Steering physical activity-oriented health interventions toward these at-risk groups in colleges may reduce the UK's burden of adolescent obesity.

Physical activity practice and sports preferences in a group of Spanish schoolchildren depending on sex and parental care: a gender perspective

BACKGROUND

Physical activity plays an important role in the maintenance of health, and it is especially important during childhood. However, the lack of information about differences in physical activity practice and sports preferences of children considering gender differences can result in non-effective policies that enhance inequalities between sexes. The aim of this study is to identify the sports preferences of Spanish schoolchildren and their physical activity practice behaviors depending on their sex and their parental care, analyzing the possible differences from a gender perspective.

METHOD

Three hundred sixty-four Spanish schoolchildren (179 girls, 185 boys) participated in this cross-sectional study. A daily physical activity questionnaire was used to evaluate physical activity level (PAL), moderate-to-vigorous physical activity (MVPA) and sports preferences and a socio-health questionnaire were used to collect data about parental care. Statistical analysis was performed using SPSS and applying Student's T-test for normal variables, Mann-Whitney U-test for non-parametrical variables, and chi-square (χ2) test for categorical variables. Subsequently, odds ratios were used to analyze associations between the physical activity practice of the children and parental care.

RESULTS

PAL and time spent in MVPA was significantly lower for girls compared to boys (1.44 ± 0.07 vs. 1.46 ± 0.07, p < 0.001 and 0.74 ± 0.40 h/day vs. 0.90 ± 0.45 h/day; p < 0.001, respectively). Dancing, rhythmic gymnastics, skating, and water sports were practiced more by girls, while football, wrestling sports, handball, and racket sports were practiced more by boys (p < 0.05). Children cared for by their fathers had higher odds for physical activity practice (OR = 1.995 (1.202-3.310), p = 0.008).

CONCLUSION

Physical activity among girls was less frequent and less intense. Girls opted for individual sports with artistic connotations, while boys often practiced more team contact sports. Furthermore, children are more physically actives when their father is in charge of them.

Prevalence of Physical Activity among Adolescents from 105 Low, Middle, and High-income Countries

Introduction: Physical activity (PA) is a beneficial health behaviour, however most adolescents worldwide are physically inactive. Updated information on the prevalence and trends of PA is important to inform national and international authorities and support countries’ public health policies and actions. This study aimed to present the worldwide, regional, and national prevalence of PA participation according to its frequency in adolescents. Methods: This study is based on cross-sectional surveys of adolescents’ populations from several countries and all regions worldwide. The sample comprised 520,533 adolescents (251,788 boys; 268,745 girls), from 105 countries and regions. Results: Most adolescents engaged in PA up to 3 days/week (57.1%; 95% CI: 56.9; 57.2). The prevalence of engaging in PA every day decreases over the age from 28.2% at age of 11–12 years (95% CI: 27.4; 29.0) to 21.2% at age of 16–17 years (95% CI: 20.3; 22.0) among boys; and from 19.4% (95% CI: 18.5; 20.2) to 11.1% (95% CI: 10.1; 12.0) among girls. For boys and girls who engaged in PA 5-6 days/week, the prevalence increases from countries with the lowest human development index to countries with the highest. Cambodia (7.3%, 95% CI: 3.8; 10.8), Philippines (7.7%, 95% CI: 5.6; 9.7), Sudan (8.8%, 95% CI: 4.7; 12.9), Timor-Leste (8.9%, 95% CI: 5.5; 12.3), and Afghanistan (10.1%, 95% CI: 6.1; 14.1) were the countries with the lowest prevalence of sufficient PA. Conclusions: National, regional, and worldwide data on the prevalence of physical activity in adolescents highlights the importance of improving the global levels of PA, especially in girls. Identifying the factors causing the age-related decrease in physical activity levels will permit public health entities to define priority actions and policies against physical inactivity.

Bidirectional Associations between Objective Physical Activity and Sleep Patterns in Spanish School Children

Physical activity (PA) and sleep contribute to better children’s health. Nonetheless, the bidirectional relationship between both of these health-related factors is unclear when using objective measures. The aims of this study were (1) to describe the PA (light PA and moderate-to-vigorous PA (MVPA) and sleep (duration, latency, and efficiency) patterns of children and compare them with recommendations, and (2) to analyze the bidirectional association between PA levels and sleep patterns in 470 Spanish children according to sex (average age of 8.4 (0.4) years, 51.9% boys). A tri-axial accelerometer and sleep logs were used to measure PA (light PA and MVPA) and sleep patterns (duration, latency, and efficiency) in the children for seven consecutive days. Linear mixed models were conducted to analyze the bidirectional association (PA → sleep and sleep → PA) adjusted for the child, the sex, the school, and the day of observation. The results showed that, overall, the children did not meet the sleep duration recommendations per day. Regarding the bidirectional association, increased light PA and MVPA during the day was related to decreased sleep duration but an improvement in sleep efficiency that night. However, sleep duration and sleep efficiency were only related negatively and positively to light PA the following day, respectively. Regarding sex, light PA was associated with decreased sleep duration in both sexes, although the average value was lower in boys. In addition, light PA was also related only to an improvement in sleep efficiency the same night in both sexes, with girls generally having more efficient sleep. More studies in a representative sample of children that use objective measures to corroborate these results are needed.