School and class-level variations and patterns of physical activity: a multilevel analysis of Danish high school students

School-level intra-cluster correlation coefficients and autocorrelations for children's accelerometer-measured physical activity in England by age and gender

BACKGROUND

Randomised, cluster-based study designs in schools are commonly used to evaluate children's physical activity interventions. Sample size estimation relies on accurate estimation of the intra-cluster correlation coefficient (ICC), but published estimates, especially using accelerometry-measured physical activity, are few and vary depending on physical activity outcome and participant age. Less commonly-used cluster-based designs, such as stepped wedge designs, also need to account for correlations over time, e.g. cluster autocorrelation (CAC) and individual autocorrelation (IAC), but no estimates are currently available. This paper estimates the school-level ICC, CAC and IAC for England children's accelerometer-measured physical activity outcomes by age group and gender, to inform the design of future school-based cluster trials.

METHODS

Data were pooled from seven large English datasets of accelerometer-measured physical activity data between 2002-18 (> 13,500 pupils, 540 primary and secondary schools). Linear mixed effect models estimated ICCs for weekday and whole week for minutes spent in moderate-to-vigorous physical activity (MVPA) and being sedentary for different age groups, stratified by gender. The CAC (1,252 schools) and IAC (34,923 pupils) were estimated by length of follow-up from pooled longitudinal data.

RESULTS

School-level ICCs for weekday MVPA were higher in primary schools (from 0.07 (95% CI: 0.05, 0.10) to 0.08 (95% CI: 0.06, 0.11)) compared to secondary (from 0.04 (95% CI: 0.03, 0.07) to (95% CI: 0.04, 0.10)). Girls' ICCs were similar for primary and secondary schools, but boys' were lower in secondary. For all ages, combined the CAC was 0.60 (95% CI: 0.44-0.72), and the IAC was 0.46 (95% CI: 0.42-0.49), irrespective of follow-up time. Estimates were higher for MVPA vs sedentary time, and for weekdays vs the whole week.

CONCLUSIONS

Adequately powered studies are important to evidence effective physical activity strategies. Our estimates of the ICC, CAC and IAC may be used to plan future school-based physical activity evaluations and were fairly consistent across a range of ages and settings, suggesting that results may be applied to other high income countries with similar school physical activity provision. It is important to use estimates appropriate to the study design, and that match the intended study population as closely as possible.

Statistical analysis of the longitudinal fundamental movement skills data in the REACT project using the multilevel ordinal logistic model

OBJECTIVES

The REACT project was designed around two main aims: (1) to assess children's growth and motor development after the COVID-19 pandemic and (2) to follow their fundamental movement skills' developmental trajectories over 18 months using a novel technological device (Meu Educativo®) in their physical education classes. In this article, our goal is to describe statistical analysis of the longitudinal ordinal motor development data that was obtained from these children using the multilevel ordinal logistic model.

METHODS

Longitudinal ordinal data are often collected in studies on motor development. For example, children or adolescents might be rated as having poor, good, or excellent performance levels in fundamental movement skills, and such ratings may be obtained yearly over time to assess changes in fundamental movement skills levels of performance. However, such longitudinal ordinal data are often analyzed using either methods for continuous outcomes, or by dichotomizing the ordinal outcome and using methods for binary data. These approaches are not optimal, and so we describe in detail the use of the multilevel ordinal logistic model for analysis of such data from the REACT project. Our intent is to provide an accessible description and application of this model for analysis of ordinal motor development data.

DISCUSSION

Our analyses show both the between-subjects and within-subjects effects of age on motor development outcomes across three timepoints. The between-subjects effect of age indicate that children that are older have higher motor development ratings, relative to thoese that are younger, whereas the within-subject effect of age indicates higher motor development ratings as a child ages. It is the latter effect that is particularly of interest in longitudinal studies of motor development, and an important advantage of using the multilevel ordinal logistic model relative to more traditional methods.

Correlates of the Physical Activity Decline during Childhood

PURPOSE

This study aimed to describe longitudinal trends in children's moderate-to-vigorous physical activity (MVPA) and to investigate associations with individual, familial, and school characteristics.

METHODS

A sample of 341 Portuguese children age 5-10 yr (173 girls) from six age cohorts was followed over 3 yr using a mixed-longitudinal design. Physical activity, body mass index (BMI), gross motor coordination, and musculoskeletal fitness were assessed annually. Information on socioeconomic status and school characteristics was collected and analyzed with mixed models.

RESULTS

MVPA shows a similar declining trend in both sexes, but on average, boys exceeded the World Health Organization recommendations of 60 min·d -1 . The best model showed that boys spend, on average, more time in MVPA than girls. Children with lower BMI are less prone to the decline in MVPA, whereas higher levels of musculoskeletal fitness were associated with lower declines in MVPA. Of all school characteristics, only playground dimension was related to MVPA decreasing trajectories.

CONCLUSIONS

MVPA systematically declines from 5 to 10 yr of age in both boys and girls, but boys remained more active than girls across the age range. The best predictors of MVPA decline are sex, BMI, musculoskeletal fitness, and school playground dimension.

The Direct and Indirect Relationships Within the Extended Trans-contextual Model for Moderate-to-vigorous Physical Activity

Given the low levels of physical activity (PA) in adolescence, there are challenges to increasing students' PA outside of the school setting. Thus, researchers emphasize the supportive role that physical education (PE) teachers can play in PA motivation both in and out of school. The aim of the present study was to examine an expanded trans-contextual model (TCM) model for the transit of teachers' perceived support of students' autonomy in terms of contextual and situational motivation in PE to objectively measured moderate-to-vigorous physical activity (MVPA) in PE across different PE contents as well as to the motivational sequence for, and participation in, subjective MVPA during leisure time. This cross-sectional study involved 283 high school students, of whom 43.9% were boys. The autonomous support students received and other motivational factors and objective measures of MVPA in PE and subjective MVPA in leisure time were measured. The results indicate that support for autonomy was significantly and directly related to needs satisfaction (β = 0.61, p < 0.001) and indirectly to autonomous motivation in PE (β = 0.19, p < 0.001) and leisure time (β = 0.16, p < 0.001), intention in PE (β = 0.03, p < 0.05) and leisure time (β = 0.07, p < 0.001), and leisure time MVPA (β = 0.04, p < 0.001), although not MVPA in PE. Gender was a significant covariate for both MVPA in PE (β = -0.62, p < 0.001) and MVPA in leisure time (β = -0.37, p < 0.001), with higher MVPA in boys than girls. This study filled a gap in the scientific literature by demonstrating the full motivational sequence resulting in actual MVPA in PE classes. It also demonstrated that the main goal of PE of enhancing PA not only in school but also outside of school is working. The main motivator is needs satisfaction based on PE teachers' support.

Back Pain Related with Age, Anthropometric Variables, Sagittal Spinal Curvatures, Hamstring Extensibility, Physical Activity and Health Related Quality of Life in Male and Female High School Students

Spinal pain (SP) is widely extended among adolescents. The origin of SP can be multifactorial; thus, the present study aimed to estimate the prevalence and risk of SP in high school students and to determine the differences in sagittal spinal curvatures and pelvic tilt, hamstring extensibility, age, anthropometric variables and healthy lifestyle habits dependent on SP between sexes. Two hundred seventy-three teenagers took part in this cross-sectional study. Age, sagittal spinal curvatures, hamstring extensibility, physical activity, sedentary lifestyle, anthropometric variables and health related quality of life (HRQL) were recorded. SP was reported by 16.12% of adolescents. Differences were observed in the HRQL according to SP (p < 0.05). Participants without SP were less sedentary (22.12%) and younger (13.10 years old) than participants with SP (40.91% and 13.66, respectively) (p < 0.05). A logistic regression model showed that both variables were significantly collinear (VIF = 1.01; Durbin-Watson = 2.10). Subjects with low back pain (LBP) had a higher weight, body max index, and hip girth than subjects without pain (p < 0.05). A misalignment in the lumbar spine was associated with LBP for males (Cramer’s V = 0.204, p = 0.022). In conclusion, adolescents with SP were older and had a lower HRQL in all dimensions. SP could be predicted according to age and sedentary habits.

A Multilevel Analysis of Neighbourhood, School, Friend and Individual-Level Variation in Primary School Children's Physical Activity

Physical activity is influenced by individual, inter-personal and environmental factors. In this paper, we explore the variability in children's moderate-to-vigorous physical activity (MVPA) at different individual, parent, friend, school and neighbourhood levels. Valid accelerometer data were collected for 1077 children aged 9, and 1129 at age 11, and the average minutes of MVPA were derived for weekdays and weekends. We used a multiple-membership, multiple-classification model (MMMC) multilevel model to compare the variation in physical activity outcomes at each of the different levels. There were differences in the proportion of variance attributable to the different levels between genders, for weekdays and weekends, at ages 9 and 11. The largest proportion of variability in MVPA was attributable to individual variation, accounting for half of the total residual variability for boys, and two thirds of the variability for girls. MVPA clustered within friendship groups, with friends influencing peer MVPA. Including covariates at the different levels explained only small amounts (3%-13%) of variability. There is a need to enhance our understanding of individual level influences on children's physical activity.

Correlates of Physical Activity of Students in Secondary School Physical Education: A Systematic Review of Literature

BACKGROUND AND OBJECTIVE

Several reviews have summarised studies on secondary school students' moderate-to-vigorous physical activity (MVPA) in physical education (PE), but no systematic review with semiquantitative assessment has been conducted to specifically identify the correlates of their MVPA. This review aims to systematically summarise the existing literature, which investigated correlates of MVPA of secondary school students during their PE lessons.

METHODS

A systematic search using ERIC, SPORTDiscus, PubMed, PsycINFO, Academic Search Premier, and Web of Science was conducted to identify the correlates of the MVPA of secondary school students in PE. Studies were eligible if they were English published articles and examined the association with MVPA during secondary school PE lessons and cross-sectional and prospective longitudinal quantitative studies. Two reviewers independently examined the articles, assessed their methodological quality, and performed data extraction. The correlates of MVPA were synthesised and further assessed semiquantitatively.

RESULTS

Fifty-five studies were identified to correlate with secondary school students' MVPA in PE lessons. Further analysis only included 43 studies (78.2%) that were of medium and high quality by methodological quality assessment. Out of 54 variables identified from these medium and high-quality studies, 11 were consistently associated with the MVPA. Sex (boys), ethnicity (White), class gender (boys-only), PE activities (team games), lesson location (outdoors), expectancy beliefs, subjective task values, and enjoyment were consistently and positively associated with MVPA. Other variables, namely, class gender (girls-only), PE activities (movement activities), and lesson context (knowledge), were consistently and negatively related to MVPA.

CONCLUSIONS

Interventions focusing on the consistent variables are needed to build active lesson time in PE. This review also provides insights for future research.