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Bandoh DA, Sunkwa-Mills G, Ernest K. Are risk factors for non-communicable diseases in adolescents a problem in senior high schools in Accra? Ghana Med J 2021; 54:59-63. [PMID: 33536670 PMCID: PMC7837348 DOI: 10.4314/gmj.v54i2s.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background We assessed risk factors of noncommunicable diseases (NCDs) among adolescents in a senior high school Design We conducted a cross-sectional study in 2016 Setting Senior High School in Accra Participants Adolescents in senior high school Interventions Adolescents were interviewed with a structured questionnaire designed using the WHO STEPS framework. Data on tobacco use, alcohol consumption, physical activity and physical measurements of respondents were taken. Main outcome measures risk factors of noncommunicable diseases among adolescents Results A total of 360 adolescents in the school were assessed. Mean age was (17±1.21) years with minimum age being 13 and maximum 19 years. Females were 51% (184/360). About 75% (271/360) reported low physical activity, 15% (55/360) were overweight or obese (95%CI: 0.0317–0.078), 7.0% (25/360) consumed alcohol (95%CI: 0.054–0.111) and 2.5% (9/360) smoked tobacco (95%CI: 0.013- 0.048). Majority of the respondents (346/360) were exposed or at risk of developing at least one risk factor. However, no one was found to be at risk of all five risk factors assessed. Females were three times more likely to be overweight or obese compared to their male counterparts (OR:3, 95%CI:1.581–5.624) Conclusion We found that majority of the children had low physical activity and more than 90% of the respondents had at least one NCD risk factor. Funding This work was funded by the authors
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Affiliation(s)
- Delia A Bandoh
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Gifty Sunkwa-Mills
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Kenu Ernest
- Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana
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Baqal OJ, Saleheen H, AlBuhairan FS. Urgent Need for Adolescent Physical Activity Policies and Promotion: Lessons from "Jeeluna". INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124464. [PMID: 32575900 PMCID: PMC7345490 DOI: 10.3390/ijerph17124464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 12/14/2022]
Abstract
Physical inactivity is a growing concern in Kingdom of Saudi Arabia (KSA) and globally. Data on physical activity (PA) trends, barriers, and facilitators among adolescents in KSA are scarce. This study aims to identify PA trends amongst adolescents in KSA and associated health and lifestyle behaviors. Data from “Jeeluna”, a national study in KSA involving around 12,500 adolescents, were utilized. School students were invited to participate, and a multistage sampling procedure was used. Data collection included a self-administered questionnaire, anthropometric measurements, and blood sampling. Adolescents who performed PA for at least one day per week for >30 min each day were considered to “engage in PA”. Mean age of the participants was 15.8 ± 0.8 years, and 51.3% were male. Forty-four percent did not engage in PA regularly. Only 35% engaged in PA at school, while 40% were not offered PA at school. Significantly more 10–14-year old than 15–19-year-old adolescents and more males than females engaged in PA (<0.01). Mental health was better in adolescents who engaged in PA (<0.01). Adolescents who engaged in PA were more likely to eat healthy food and less likely to live a sedentary lifestyle (<0.01). It is imperative that socio-cultural and demographic factors be taken into consideration during program and policy development. This study highlights the urgent need for promoting PA among adolescents in KSA and addressing perceived barriers, while offering a treasure of information to policy and decision makers.
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Affiliation(s)
- Omar J. Baqal
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia;
| | - Hassan Saleheen
- National Family Safety Program, King Abdulaziz Medical City-Ministry of National Guard Health Affairs, Riyadh 11426, Saudi Arabia;
| | - Fadia S. AlBuhairan
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia;
- Department of Pediatrics & Adolescent Medicine, Aldara Hospital and Medical Center, Riyadh 12714, Saudi Arabia
- Correspondence: or
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Craike M, Bourke M, Hilland TA, Wiesner G, Pascoe MC, Bengoechea EG, Parker AG. Correlates of Physical Activity Among Disadvantaged Groups: A Systematic Review. Am J Prev Med 2019; 57:700-715. [PMID: 31630762 DOI: 10.1016/j.amepre.2019.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Socioeconomically disadvantaged adults have lower engagement in leisure-time physical activity than those who are more affluent. Identification of correlates of physical activity can inform the design of effective interventions. The aim of this systematic review was to identify consistent correlates of unspecified physical activity and leisure-time physical activity among socioeconomically disadvantaged adults. EVIDENCE ACQUISITION PubMed and Scopus were searched up to May 2018, and titles/abstracts and full texts were screened against eligibility criteria. Methodologic quality was assessed, and correlates were synthesized from July to September 2018. EVIDENCE SYNTHESIS Seventy-three studies were selected for synthesis; 48 examined unspecified physical activity and 31 examined leisure-time physical activity (6 examined both). Self-rated health, functional capacity, and physical activity self-efficacy were consistently, positively associated with unspecified physical activity. Mental health status and perceived benefits and enjoyment of physical activity were consistently, positively associated with leisure-time physical activity. Most studies were cross-sectional and used validated self-report measures of physical activity; few reported response rates >50%. CONCLUSIONS Few factors were consistently associated with either unspecified physical activity or leisure-time physical activity. Based on available evidence, strategies to increase physical activity should consider the needs of, and focus on, those with poor self-rated health and functional capacity and should use strategies to improve physical activity self-efficacy. Strategies to increase leisure-time physical activity should focus on simultaneously addressing leisure-time physical activity and mental health concerns and improving perceptions of physical activity benefits and enjoyment. It is recommended that future studies focus on leisure-time physical activity, focus on men, use longitudinal design, examine variables related to behavioral attributes and skills, and carefully consider and plan recruitment strategies.
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Affiliation(s)
- Melinda Craike
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia; Mitchell Institute, Victoria University, Melbourne, Victoria, Australia.
| | - Matthew Bourke
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Toni A Hilland
- School of Education, College of Design and Social Context, Bundoora, Victoria, Australia
| | - Glen Wiesner
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia; Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Enrique Garcia Bengoechea
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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Itoh H, Kitamura F, Hagi N, Mashiko T, Matsukawa T, Yokoyama K. Leisure-time physical activity in youth as a predictor of adult leisure physical activity among Japanese workers: a cross-sectional study. Environ Health Prev Med 2017; 22:37. [PMID: 29165133 PMCID: PMC5664430 DOI: 10.1186/s12199-017-0648-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/22/2017] [Indexed: 12/03/2022] Open
Abstract
Background Workers in Japan are not sufficiently active; however, it remains unclear how their leisure-time physical activity habits may be developed. This cross-sectional study investigated the relationship of age- and intensity-specific leisure-time physical activity in youth to adulthood leisure-time physical activity habits among Japanese workers. Methods In 2012, 968 workers (333 males and 635 females) from three companies and six hospitals in the Tokai region of Japan agreed to complete and submit a self-administered questionnaire. Intensity-specific leisure-time physical activity at ages 12 and 20 years was assessed retrospectively, and workers’ current participation in regular leisure-time physical activity was assessed as an outcome measure. Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis. Results Mean ages for males and females were 40 and 37 years, respectively. Strenuous leisure-time physical activity at age 12 years was significantly positively associated with adulthood participation in leisure-time physical activity among male workers [adjusted OR (95% CI) = 2.29 (1.02, 5.14)]. Additionally, both strenuous and moderate physical activity at age 20 years was significantly positively associated with participation in regular leisure-time physical activity in adulthood among males and females. Conclusions Our results suggest that some leisure-time physical activity in youth may predict adult workers’ participation in regular leisure-time physical activity in Japan. Encouragement of leisure-time physical activity in youth could therefore be an effective measure to develop adult leisure-time physical activity habits among workers.
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Affiliation(s)
- Hiroaki Itoh
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Fumihiko Kitamura
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Noriko Hagi
- Yokkaichi Nursing and Medical Care University, Yokkaichi, Japan
| | - Tomoe Mashiko
- Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Takehisa Matsukawa
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kazuhito Yokoyama
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
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Kelishadi R, Qorbani M, Djalalinia S, Sheidaei A, Rezaei F, Arefirad T, Safiri S, Asayesh H, Motlagh ME. Physical inactivity and associated factors in Iranian children and adolescents: the Weight Disorders Survey of the CASPIAN-IV study. J Cardiovasc Thorac Res 2017; 9:41-48. [PMID: 28451087 PMCID: PMC5402026 DOI: 10.15171/jcvtr.2017.06] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 03/03/2017] [Indexed: 02/01/2023] Open
Abstract
Introduction: This study aims to assess the associated factors of physical inactivity among Iranian children and adolescents at national level. The second objective is to assess the relationship of physical inactivity with anthropometric measures. Methods: Along with a national surveillance program, this survey on weight disorders was conducted among a nationally-representative sample of Iranian children and adolescents, aged 6-18 years. Students were selected by multi-stage cluster sampling from rural and urban areas of 30 provinces of Iran. The Physical Activity Questionnaire for Adolescents (PAQ-A) was used to assess physical activity (PA). Using PAQ-A instrument, PA of past week categorized as; low PA level, that included those who scored between 1 to 1.9 on the PAQ-A instrument and high PA level that included participants with estimated scores between 2-5 PAQ-A. Results: Participants were 23183 school students (50.8% boys) with a mean age of 12.55 ± 3.3 years, without significant difference in terms of gender. Totally, 23.48% of participants (13.84% of boys and 33.42% of girls) were physically inactive. In multivariate logistic regression model, with increased age in children and adolescence, the odds of a physically inactivity increased (OR: 1.08; 95% CI: 1.07-1.10). The odds of prevalence of both obesity and underweight were high in children and adolescents with low PA. There was a decreasing trend in PA in higher school grades. Conclusion: We found a considerably high prevalence of physical inactivity in Iranian children and adolescents, with higher rates among girls and older ages. However, we did not find correlation between PA and socioeconomic status (SES). Because of the positive relationship between PA and ST, future studies should consider the complex interaction of these two items. Multidisciplinary policies should be considered in increasing PA programs among children and adolescents.
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Affiliation(s)
- Roya Kelishadi
- Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Fatemeh Rezaei
- Department of Social Medicine, Medical School, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Tahereh Arefirad
- Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
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Alves AR, Marta CC, Neiva HP, Izquierdo M, Marques MC. Concurrent Training in Prepubescent Children: The Effects of 8 Weeks of Strength and Aerobic Training on Explosive Strength and V̇o 2max. J Strength Cond Res 2016; 30:2019-32. [DOI: 10.1519/jsc.0000000000001294] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Mäki-Opas TE, de Munter J, Maas J, den Hertog F, Kunst AE. The association between physical environment and cycling to school among Turkish and Moroccan adolescents in Amsterdam. Int J Public Health 2014; 59:629-36. [PMID: 24875353 DOI: 10.1007/s00038-014-0565-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 03/16/2014] [Accepted: 05/08/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES This study examined the effect of physical environment on cycling to and from school among boys and girls of Turkish and Moroccan origin living in Amsterdam. METHODS The LASER study (n = 697) was an interview study that included information on cycling to and from school and the perceived physical environment. Objective information on physical environment was gathered from Statistics Netherlands and the Department for Research and Statistics at the Municipality of Amsterdam. Structural equation modelling with latent variables was applied, taking into account age, gender, self-assessed health, education, country of origin, and distance to school. RESULTS For every unit increase in the latent variable scale for bicycle-friendly infrastructure, we observed a 21% increase in the odds for cycling to and from school. The association was only borderline statistically significant and disappeared after controlling for distance to school. The enjoyable environment was not associated with cycling to and from school after controlling for all background factors. CONCLUSIONS Bicycle-friendly infrastructure and an enjoyable environment were not important factors for cycling to and from school among those with no cultural cycling background.
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Affiliation(s)
- Tomi E Mäki-Opas
- Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands,
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Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: a systematic review. Int J Behav Nutr Phys Act 2012; 9:116. [PMID: 22992350 PMCID: PMC3491027 DOI: 10.1186/1479-5868-9-116] [Citation(s) in RCA: 320] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 09/04/2012] [Indexed: 11/24/2022] Open
Abstract
Background This study systematically reviewed the evidence pertaining to socioeconomic inequalities in different domains of physical activity (PA) by European region. Methods Studies conducted between January 2000 and December 2010 were identified by a systematic search in Pubmed, Embase, Web of Science, Psychinfo, Sportdiscus, Sociological Abstracts, and Social Service Abstracts. English-language peer-reviewed studies undertaken in the general population of adults (18–65 years) were classified by domain of PA (total, leisure-time including sport, occupational, active transport), indicator of socioeconomic position (education, income, occupation), and European region. Distributions of reported positive, negative, and null associations were evaluated. Results A total of 131 studies met the inclusion criteria. Most studies were conducted in Scandinavia (n = 47). Leisure-time PA was the most frequently studied PA outcome (n = 112). Considerable differences in the direction of inequalities were seen for the different domains of PA. Most studies reported that those with high socioeconomic position were more physically active during leisure-time compared to those with low socioeconomic position (68% positive associations for total leisure-time PA, 76% for vigorous leisure-time PA). Occupational PA was more prevalent among the lower socioeconomic groups (63% negative associations). Socioeconomic differences in total PA and active transport PA did not show a consistent pattern (40% and 38% positive associations respectively). Some inequalities differed by European region or socioeconomic indicator, however these differences were not very pronounced. Conclusions The direction of socioeconomic inequalities in PA in Europe differed considerably by domain of PA. The contradictory results for total PA may partly be explained by contrasting socioeconomic patterns for leisure-time PA and occupational PA.
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Terry-McElrath YM, O’Malley PM. Substance use and exercise participation among young adults: parallel trajectories in a national cohort-sequential study. Addiction 2011; 106:1855-65; discussion 1866-7. [PMID: 21561496 PMCID: PMC3174354 DOI: 10.1111/j.1360-0443.2011.03489.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS This study examined the extent to which the trajectory of participation in sports, athletics or exercising (PSAE) covaried with substance use in early adulthood controlling for team sports participation using parallel process latent growth curve modeling. DESIGN, SETTING AND PARTICIPANTS Analysis of data collected from a series of panel studies using a cohort-sequential design. Specifically, the analyses used longitudinal data from 11 741 individuals from the graduating classes of 1986-2001, first surveyed as seniors in American high schools. Up to four additional follow-up surveys were administered to age 26 years. Data were collected using in-school and mailed self-administered questionnaires. MEASUREMENTS Level of PSAE, past-30-day alcohol, cigarette and marijuana use frequency and any past-30-day use of illicit drugs other than marijuana (IOTM) were the main processes of interest. Self-reported race/ethnicity, college status at age 19/20 years, parental education, gender and team sports participation during high school were included as covariates. FINDINGS Results indicate that higher initial levels of PSAE related to lower initial substance use prevalence rates other than alcohol, and lower initial prevalence rates of substance use then corresponded with lower substance use rates throughout early adulthood. Further, as individuals increased PSAE levels throughout early adulthood, the frequency of their use of cigarettes, marijuana and IOTM correspondingly decreased. CONCLUSIONS Increased participation in sports, athletics or exercising (PSAE) is related to significantly lower substance use frequency at modal age 18 and through significantly and negatively correlated growth trajectories through early adulthood. Encouraging PSAE among adolescents and early adults may relate to lower substance use levels throughout early adulthood.
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Affiliation(s)
- Yvonne M. Terry-McElrath
- Institute for Social Research, University of Michigan, Ann Arbor,Correspondence may be sent to Yvonne Terry-McElrath at Institute for Social Research, PO Box 1248, Ann Arbor MI 48106-1248. Telephone: 734-647-9142. Fax: 734-936-0043.
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Mäkinen TE, Sippola R, Borodulin K, Rahkonen O, Kunst A, Klumbiene J, Regidor E, Ekholm O, Mackenbach J, Prättälä R. Explaining educational differences in leisure-time physical activity in Europe: the contribution of work-related factors. Scand J Med Sci Sports 2010; 22:439-47. [DOI: 10.1111/j.1600-0838.2010.01234.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Kelishadi R, Ghatrehsamani S, Hosseini M, Mirmoghtadaee P, Mansouri S, Poursafa P. Barriers to Physical Activity in a Population-based Sample of Children and Adolescents in Isfahan, Iran. Int J Prev Med 2010; 1:131-7. [PMID: 21566774 PMCID: PMC3075475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 12/02/2009] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES This study was conducted to explore the barriers to physical activity in a representative sample of Iranian children and adolescents. METHODS The study was conducted in 2007 in urban and rural areas of Isfahan district in Iran. In the qualitative part, we used the grounded theory approach, including semi-structured focus group discussions and indepth interviews. The quantitative part comprised 600 randomly selected students. RESULTS The qualitative study included 34 school students (16 girls), 20 parents (11 mothers) and 11 school staff. All students disclosed that studying was a priority. They pointed to lack of safe and easy-access place for physical activity and unsupportive family as the main barriers. Lack of self-confidence and low selfworth were the two other concepts developed in this context. Parents pointed to lack of safe and easy-access place for activity followed by the priority of studying. The concepts derived from interviews with school staff included unhealthy modeling of parents, priority of studying, and inadequate public knowledge about how to integrate physical activity in routine daily life. The quantitative survey comprised 600 students including 286 (47.8%) girls. Parents' education level had inverse association with children's physical activity level. Significant inverse associations of self-efficacy and physical activity levels were documented. CONCLUSIONS Increasing the public knowledge about adopting physical activity habits in routine daily life, informing the families and students about the benefits of physical activity to improve learning, as well as providing safe places such as using the school facilities in non-school hours should be considered in planning effective preventive strategies and interventions.
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Affiliation(s)
- Roya Kelishadi
- Professor of Pediatrics, Departmentof Pediatric Preventive Cardiology, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences (IUMS), Isfahan, Iran,Correspondence to: Roya Kelishadi, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Shohreh Ghatrehsamani
- Research Assistant, Department of Pediatric Preventive Cardiology, Isfahan Cardiovascular Research Center, IUMS, Isfahan, Iran
| | - Mohsen Hosseini
- Assistant Professor of Biostatistics, Department of Biostatistics& Epidemiology, School of Public Health, IUMS, Isfahan, Iran
| | | | - Samaneh Mansouri
- Biostatistician, Department of Biostatistics& Epidemiology, School of Public Health, IUMS, Isfahan, Iran
| | - Parinaz Poursafa
- Research Assistant, Department of Pediatric Preventive Cardiology, Isfahan Cardiovascular Research Center, IUMS, Isfahan, Iran
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