"Are Thai children and youth sufficiently active? prevalence and correlates of physical activity from a nationally representative cross-sectional study"

Thai Preschoolers' movement behaviors outside kindergarten: prevalence of meeting individual and integrated movement guidelines

BACKGROUND

This study aimed to investigate movement behaviors of Thai preschoolers (aged 3-6 years) occurring outside kindergarten in urban areas across Thailand.

METHODS

Surveillance of digital Media in eArLy chiLdhood Questionnaire® was used to collect data from 1051 parents recruited from 12 schools. Descriptive statistics and logistic regressions were applied for data analysis.

RESULTS

Thai preschoolers engaged in physical activity (PA), sedentary screen time, and sleep on weekends significantly more than weekdays with no significant sex differences. Preschoolers met the sleep guidelines the most (62.3%), followed by PA guidelines (48.0%), and screen time (ST) guidelines the least (44.1%). Only 14.6% met the integrated movement guidelines, and 11% met none of the guidelines. Age was positively associated with meeting the PA guidelines, and negatively associated with meeting the sleep and integrated movement guidelines. The number of digital devices at home and geographical region influenced preschoolers in meeting the PA and ST guidelines.

CONCLUSIONS

Thai preschoolers' time spent on all forms of activities outside kindergarten was significantly more on weekends than weekdays with no sex disparity. The prevalence of meeting the integrated movement guidelines was low, and needs to be addressed through comprehensive programs including all forms of activities concurrently.

IMPACT

Thai preschoolers engaged in physical activity (PA), screen time (ST), and sleep on weekends significantly more than weekdays with no significant sex differences. Only 14.6% of preschoolers met the integrated movement guidelines. Age had a significant relationship with meeting the PA, sleep, and integrated movement guidelines. Meeting the PA and ST guidelines in preschoolers was positively associated with the number of digital devices at home. Despite some limitations, this study presented preschoolers' time engaged in the three movement behaviors concurrently, and provided important inputs for development of the national strategic plan to promote PA among Thai children and youth.

Ecological correlates of sport and exercise participation among Thai adolescents: A hierarchical examination of a cross-sectional population survey

BACKGROUND

Understanding factors influencing adolescents' sport/exercise participation (S/EP) is vital to developing effective interventions, but currently, evidence from less developed countries is limited. The purpose of this study was to examine correlates of S/EP across individual, interpersonal, and environmental levels in a nationally representative sample of Thai adolescents.

METHODS

Data from 4617 Thai adolescents aged 14-17 years old were obtained from recruited schools across Thailand. Data on S/EP (outcome variable), and psychosocial, home, and community environment covariates were collected from individual adolescents using the Thailand Physical Activity Children Survey, Student Questionnaire. School environmental data were collected at the school level using a School Built Environment Audit. Hierarchical regressions taking into account school clustering effects were applied for data analysis.

RESULTS

At the individual level, age and body mass index were independently and strongly correlated with S/EP. Adolescents with high preference for physical activity (PA) (odd ratio (OR) = 1.71, p < 0.001) and at least a moderate level of self-efficacy (OR = 1.33, p = 0.001) were more likely to have high S/EP. At the interpersonal level, adolescents whose parents joined their sports/exercise at least 1-2 times/week (OR = 1.36, p = 0.003) received ≥3 types of parental support (OR = 1.43, p = 0.005) and who received siblings' (OR = 1.26, p = 0.004) and friends' (OR = 1.99, p < 0.001) support had a greater chance of high S/EP. At the environmental level, adolescents' S/EP was greater when there were at least 3-4 pieces of home sport/exercise equipment (OR = 2.77, p = 0.003), grass areas at school (OR = 1.56, p < 0.001), and at least 1-2 PA facilities in the community (OR = 1.30, p = 0.009).

CONCLUSION

Multiple factors at different levels within an ecological framework influencing Thai adolescents' S/EP were generally similar to those found in developed countries, despite some differences. For those interested in promoting and supporting Thai adolescents' engagement in sports/exercise, further exploration of the influence of self-efficacy and attitude toward PA is required at the individual level; parental and peer support at the interpersonal level; and home sport equipment, school grass areas, and neighborhood PA facilities at the environment level.

Is There Any Relationship between Physical Activity Levels and Academic Achievement? A Cross-Cultural Study among Spanish and Chilean Adolescents

The current scientific literature has shown significant disparity in results when physical activity is linked to academic achievement among adolescents. Thus, the main objectives of this study were (1) to analyze the relationship among students’ academic achievement, intention to be physically active, and physical activity levels depending on the country (Spain or Chile), as well as to analyze these relationships based on students’ socio-economic status, type of school, school year, gender, and body mass index; and (2) to analyze the differences between all these variables depending on the students’ country and gender. In total, 3052 adolescents participated in the research (14.58 ± 1.39 years): 734 Chilean students (336 males and 398 females) and 2318 Spanish students (1180 males and 1138 females). Various questionnaires were used to measure the study variables. The results revealed significant relationships between academic achievement and the rest of the variables in Spanish adolescents, but in the Chilean population, academic achievement was significantly related only to socio-economic status and the type of school. Moreover, Spanish students obtained higher scores, especially the males, except for academic achievement, which was higher in females. There were also significant differences in academic achievement, intention to be physically active, physical activity levels, and socio-economic status depending on the country, with all scores being higher in Spain. Given the results, the country seems to be an important factor when comparing academic achievement and physical activity levels, besides other demographic variables.

de la Cruz MH, Car J, Chia M. University students' overall and domain-specific physical activity during COVID-19: A cross-sectional study in seven ASEAN countries

This research investigated the overall and domain-specific physical activity (PA) of university students in the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional study was applied to socioeconomic (SE) and PA online data collected from 15,366 students across 17 universities in seven Association of Southeast Asian Nations (ASEAN) countries. Statistical analyses using logistic regressions established SE-PA relationships. Over half (60.3%) of ASEAN university students met age-span specific PA guidelines. Students participated in recreational PA the most, followed by study-related activities and 44.1% of students engaged in >8 hrs/day of sedentary time (ST). Compared to students with a normal body mass index (BMI), students who were underweight (UW), overweight (OW), and obese (OB) respectively, had a 14% (UW odds ratio (OR) = 1.14, p = 0.005), 25% (OW OR = 1.25, p < 0.001), and 24% (OB OR = 1.24, p = 0.005) greater probability of meeting PA guidelines. Those who engaged in active transport and belonged to a sports club (SC) had 42% (SC OR = 0.58, p < 0.001, for both) less probability of meeting the PA guidelines, compared with those who travelled inactively and did not belong to a sports club, respectively. Students who participated in 4-6 sport or exercise activities had ten times more likelihood of meeting PA guidelines (OR = 10.15, p < 0.001), compared with those who did not play any sport or do any exercise. Students who spent >8 hrs/day of ST had 32% (ST OR = 0.68, p < 0.001) less probability of meeting PA guidelines, compared with those who spent <3 hrs of ST. These data showed that over half of ASEAN university students achieved PA guidelines and were highly sedentary during the COVID-19 pandemic. Recreational and study-related activities were important for students to maintain sufficient PA and should be actively promoted within the restrictions imposed during periods of the COVID-19 pandemic lockdowns.

Is Participation in Physical Education Classes Related to Physical Activity and Sedentary Behavior? A Systematic Review

Background: The aim of this systematic review was to summarize the results and assess the methodological quality of studies that analyzed the relation between physical education participation, physical activity, and sedentary behavior in schoolchildren. Methods: Searches were conducted for original cross-sectional and longitudinal observational studies published in Portuguese, English, and Spanish between January 2007 and August 2020, on the PubMed, Web of Science, Scientific Electronic Library Online, Education Resources Information Center, and Scopus databases. Results: A total of 60 articles (68 independent samples) were included in the revision (58 cross-sectional and 2 longitudinal observational studies). With regard to methodological quality, 27%, 52%, and 21% of the studies were classified as high, moderate, and low methodological quality, respectively. Physical activity was analyzed in 93% of the studies (n = 56) and sedentary behavior in 33% (n = 20). The higher frequency of physical education participation was associated with higher physical activity levels (56 of 68 results – 54/65 cross-sectional and 2/3 longitudinal studies) and less sedentary behavior (14 of 24 results), even after stratifying analyses by type and methodological quality. Conclusion: Physical education class participation may contribute to students being physically more active and less likely to engage in sedentary behavior.

Translation, Cross-Cultural Adaptation, and Validation of the Persian Version of Thailand Physical Activity Children Survey Questionnaire

Background

According to the importance of physical activity in the child's physical and mental development and cognitive health, developing a valid, reliable, and comprehensive assessment tool for children's physical activity is mandated. The purpose of this study is the translation, cross-cultural adaptation, and validation of the Persian version of the Thailand Physical Activity Children Survey questionnaire to measure the level of physical activity in children aged between 6-9 years in Iran.

Methods

This study consisted of three stages, first, the questionnaire translation into Persian language and modification of the sections according to the Iranian culture, then the evaluation of the questionnaire via a pilot study, and finally, assessing the reliability and validity of the tool. Participants of the pilot study were 250 healthy children, aged 6 to 9 years, meeting eligibility criteria, recruited through a stratified cluster sampling method from schools across Tehran.

Results

The Persian version of the questionnaire demonstrated an acceptable content validity (Content Validity Index between 0.88-1). The test-retest reliability reported the Intra-Class Correlation coefficient in the acceptable range in all sections (between 0.71-1). Cronbach's alpha was reported 0.993, which indicated excellent internal consistency.

Conclusions

According to the acceptable validity and reliability of the Persian version of the Thailand Physical Activity Children Survey for children aged 6-9 years, it is recommended in research and surveillance studies to determine the level of physical activity of children of that age group in Iran.

Assessing adolescent diet and physical activity behaviour, knowledge and awareness in low- and middle-income countries: a systematised review of quantitative epidemiological tools

PURPOSE

Quantitative epidemiological tools are routinely used to assess adolescent diet and physical activity (PA) constructs (behaviour, knowledge, and awareness) as risk factors for non-communicable diseases. This study sought to synthesize evidence on the quantitative epidemiological tools that have been used to assess adolescent diet and PA constructs in low to middle-income countries (LMIC).

METHODS

A systematised review was conducted using 3 databases (EbscoHost, Scopus and Web of Science).

RESULTS

We identified 292 LMIC studies assessing adolescent diet and PA. Identified studies predominantly explored behavioural (90%) constructs with a paucity of studies investigating knowledge and awareness. The majority of studies used subjective (94%) and self-administered (78%) tools. Only 39% of LMIC studies used tools validated for their contexts.

CONCLUSIONS

The findings highlight the need for more contextual tools for assessing adolescent diet and PA in LMICs. Diet and PA measurement tools used in future research will need to incorporate measures of knowledge and awareness for a more comprehensive understanding of the epidemiology of diet and PA in adolescents. Furthermore, there is a need for more evidence on the reliability and validity of these tools for use, in both cross sectional and longitudinal studies, in LMIC contexts.

Social Cognitive and Ecological Factors Influence Physical Activity Among Thai Adolescents

BACKGROUND

The aim of this study was to examine the intrapersonal, social, and physical environmental factors associated with physical activity (PA) practice in Thai adolescents.

METHODS

A total of 5536 adolescents aged 14-17 years participated in the survey. Confirmatory factor analyses and structural equation modeling were conducted to determine associations between intrapersonal, social, and physical environmental factors with PA.

RESULTS

The mean age of participants was 15.50 (1.12) years. Community environment had an overall effect on PA (β = 0.08). Perceived family support had direct (β = -0.14) and indirect (β = 0.17) effects on PA through perceived barriers (β = 0.14). Perceived barriers were directly related to PA (β = -0.23) and indirectly (β = -0.16) related to PA through self-efficacy (β = -0.14) and through perceived benefits and self-efficacy (β = -0.02). Perceived usefulness was indirectly related to PA through self-efficacy (β = 0.07). Self-efficacy was directly related to PA (β = 0.43). Girls were more likely to report more perceived barriers (βtotal = 0.13). The model explained 45% of the variance in PA.

CONCLUSION

Self-efficacy and perceived barriers are important intrapersonal factors, whereas perceived family support is an important interpersonal factor for PA among Thai adolescents.

Compliance with a physical activity guideline among junior high school students

BACKGROUND

There were no nationwide moderate- to vigorous-intensity physical activity (MVPA) data relating to Japanese adolescents. This study assessed compliance with an MVPA guideline by adolescents, using a random sampling survey in Japan. The factors associated with compliance with the guideline were also examined.

METHODS

Participants were first- to third-grade Japanese junior high school students (307 boys and 255 girls). We analyzed data from the National Sports-Life Survey of Teens 2019, which used the Japanese version of physical activity (PA) questions in the World Health Organization Health Behavior in School-aged Children survey and potential correlates of MVPA.

RESULTS

Compliance with the PA guideline by the World Health Organization for Japanese students was 19.0% (95% confidence interval (CI), 15.8-22.3). The compliance of boys was significantly higher than that of girls (23.1%; 95% CI, 18.4-27.8; vs 14.1%; 95% CI, 9.8-18.4). The odds of meeting the PA guideline were significantly higher for boys in the second grade than boys in the first grade (odds ratio (OR) 1.78; 95% CI, 1.02-3.09), liking PA (for all: OR: 2.97; 95% CI, 1.32-6.69; for girls: OR: 2.99; 95% CI, 1.01-8.81), and sports participation (for all: OR: 4.77; 95% CI, 2.32-9.80; for boys: OR: 6.00; 95% CI, 1.81-19.89; for girls: OR: 4.08; 95% CI, 1.63-10.21).

CONCLUSIONS

The results suggest that more than 80% of junior high school students were insufficiently physically active in Japan. Preferences for PA and sports participation may be important correlates of sufficient PA.

Proportion of School Attending Adolescents Meeting the Recommended Moderate-to-Vigorous Physical Activity Level and Its Predictors in Lagos, Nigeria

We aimed to assess the proportion of school attending adolescents who reached the recommended moderate-to-vigorous physical activity (MVPA) level in Lagos State, Nigeria, as well as the predictors associated with it. A cross-sectional study was conducted among 720 adolescents aged 12-19 years from 20 schools in Lagos State in 2020. MVPA level was assessed using the Activity Questionnaire for Adults and Adolescents. Predictors assessed were socio-demographic variables, anthropometric measurements, sedentary behaviour, self-efficacy, perceived benefits, and perceived barriers. Complete data was provided by 528 adolescents for the study (73% response rate). The recommended MVPA level was reached by 82.8% (95% CI 79.3-85.7) of the participants. Participants spent a median time of 44 (IQR 12.9, 110) minutes of MVPA per day on household-based activities, followed by school-based activities (21.4; 4.3, 50.4), active transportation (14.3; 0, 35), sport-based activities (8.6; 0, 58.9) and leisure-based activities (8.6; 1.1, 34.3). Participants in public schools were four times more likely to meet the recommended MVPA level compared to those in private schools (OR 3.97, 95% CI 2.46-6.42). A high proportion of school adolescents met the recommended MVPA level in Lagos State, Nigeria. Our study suggests that interventions for promoting MVPA should be targeted to private schools.

Prevalence and Trends of Physical Activity in Thai Children and Young People: Pooled Panel Data Analysis from Thailand's Surveillance on Physical Activity 2012-2020

This study aims to describe the level and trends of physical activity (PA) in Thai children and young people and examine PA changes during transitional periods. Employing nine rounds of Thailand's Surveillance on Physical Activity (SPA) 2012-2020, this study pooled three sets of data and included children and young people aged 6-17 years in the analysis: 1595 in SPA2012-2016, 1287 in SPA2017-2019, and 853 persons in SPA2020. Face-to-face interviews were conducted in five regions, 13 provinces, and 36 villages in SPA2012-2019, whereas an online survey was administered in all provinces in SPA2020. The prevalence of sufficient moderate-to-vigorous PA (MVPA) among Thais aged 6-17 years ranged from 19.0 percent to 27.6 percent, with a significant drop during the period of COVID-19 spread in 2020. The average daily MVPA ranged from 46 to 57 min and dropped to 36 min during the pandemic. Boys were consistently more active than girls in all nine rounds of the SPA, and girls had more difficulty in maintaining or improving their PA level. A significant increase in the proportion of Thai children and young people with sufficient MVPA was observed during their transition from late primary to early secondary school grades.

Relationship between the skeletal muscle mass index and physical activity of Japanese children: A cross-sectional, observational study

Regular physical activity is an important component of physical health of children and has been associated with increasing skeletal muscle mass and muscle strength. Children with low levels of physical activity may experience health problems, such as loss of muscle mass, later in life. Thus, it may be valuable to identify declining physical function in children who do not perform the recommended amount of physical activity. Therefore, we aimed to evaluate the relationship between the amount of physical activity performed for ≥60 min per day for ≥5 days per week and the skeletal muscle mass index and physical function in young children. In total, 340 typically developing children aged 6–12 years (175 girls; average age, 9.5±1.9 years) were included in this cross-sectional study. We evaluated the proportion of children performing the recommended minimum of 60 min of daily moderate-to-vigorous physical activity at least 5 days per week. The skeletal muscle mass and Gait Deviation Index scores, gait speed, grip strength, Five Times Sit-to-Stand test results, Timed Up-and-Go test results, one-leg standing time, and gait efficiency were evaluated. Multiple logistic regression analyses were performed to assess the association of moderate-to-vigorous physical activity with the skeletal muscle mass index, percent body fat, and physical function, after controlling for confounding factors (age and sex). A logistic regression analysis revealed that the skeletal muscle mass index was independently associated with moderate-to-vigorous physical activity (odds ratio, 2.34; 95% confidence interval, 1.17–4.71; P = 0.017). Performance of moderate-to-vigorous physical activity for ≥5 days per week for ≥60 min per day was associated with the skeletal muscle mass index score of Japanese children. Our findings highlighted the importance of performing moderate-to-vigorous physical activity for the development of skeletal muscle mass in children.

Physical activity level of Thai children and youth: Evidence from Thailand's 2018 report card on physical activity for children and youth

BACKGROUND

While enabling and supporting factors have been in place to facilitate the pupils to be more active, only a fourth of Thai children have met the WHO recommendation.

OBJECTIVE

This study aims to present the physical activity (PA) level of Thai children and youth, based on the indicators established by Active Health Kids Global Alliance's Report Card (RC).

METHODS

The 2016 Thailand RC Survey and the 2015-2017 Thailand's Surveillance on Physical Activity (SPA) were employed for the analysis. PA of Thai children aged 6-17 years old was assessed in 9 aspects 1) Overall PA, 2) Organized Sports and PA, 3) Active Play, 4) Active Transportation, 5) Sedentary Behavior, 6) Family and Peers, 7) School, 8) Community and Environment, and 9) Government.

RESULTS

Only 26.2% of Thai children and youth met the recommended level of 60 min MVPA. Boys are generally more active compared to girls in all age groups (34.9% versus 16.3%, respectively). Almost half had participated in organized sports and/or PA program, but only 8.7% of Thai children and youth engaged in unstructured/unorganized active play. The settings and source of influence indicators achieved better grades, shown by 71.0% of family members (e.g., parents, guardians) facilitated PA and sports opportunities for their children.

CONCLUSION

Although schools' facilities are available, Thai curriculum provides less opportunity for the children to move during classes and have enough playing time during recess. As there is no standardized guidance for PA in Thai schools, Thailand needs to promote a unified PA in order to improve PA and to reduce recreational screen time of children and youth.

School policies and practices associated with Thai children's overall and domain specific physical activity

School has a significant role in providing opportunities for children to engage in physical activity (PA) through policies and practices. This study aimed to identify the prevalence of school policies and practices related to physical activity (PA) and their association with Thai students’ overall and domain specific PA. This cross-sectional analysis included 5,830 students aged 6–17 years from 136 schools recruited though a multi-stage stratified cluster sampling across Thailand. Student’s PA data were assessed using a student survey and school data were collected by a principal survey. Associations between students’ PA and school variables were examined using logistic regressions. Despite a high prevalence of Thai schools reporting many policies and practices promoting PA in different areas, students reported low levels of PA. None of the school PA policies and practices was associated with students’ overall and domain specific activities, with active transport as the one exception. When schools had an active transport policy, students were 40% (OR = 1.40, p = 0.01) more likely to travel actively to/from school. The identified positive relationship between school active transport policy and students’ active travel behavior suggests a potential wider adoption of the policy promoting school active transport aiming to increase student’s PA levels among all Thai schools. Intervention studies are necessary to confirm this finding. Our study also reflected that, for greater levels of children’s school-based PA, strategies to translate the existing school PA policies into effective implementation should be an emphasis for Thai schools.

European Countries Ranking and Clustering Solution by Children’s Physical Activity and Human Development Index Using Entropy-Based Methods

The aim of the present study is to propose a new approach for evaluating and comparing European countries using indicators of the children physical activity and the human development index. The Global Matrix 3.0 on physical activity for children and youth and human development index data on the 18 European countries were used. MADM (multi-attribute decision making) approach was applied for this task. The criteria weights calculated by applying the weight balancing method—weight balancing indicator ranks accordance (WEBIRA). New methodology of interval entropy is proposed for determining the priority of criteria separately in each group. The novel approach of α-cuts for recursive procedure of ranking the alternatives was used. For comparison, three alternative entropy-based methods—entropy method for determining the criterion weight (EMDCW), method of criteria impact LOSs and determination of objective weights (CILOS) and integrated determination of objective criteria weights (IDOCRIW) were applied to address this MADM problem. Cluster analysis of European countries carried out using results obtained by all above methods. Comparison of the MADM methods revealed that three alternative methods assigned negligible values to whole group of criteria. Meanwhile, WEBIRA family methods performed the ranking of European countries according to the interrelation of the two groups of criteria in a balanced way. Thus, when addressing MADM tasks with two or more naturally related sets of criteria, it is appropriate to apply criteria adapted for that purpose, such as WEBIRA.

Prevalence and Correlates of Physical Activity Among Children and Adolescents: A Cross-Sectional Population-Based Study of a Rural City in Japan

BACKGROUND

Although moderate-to-vigorous physical activity (MVPA) has multiple health benefits, current participation in recommended MVPA level and its determinants among Japanese children and adolescents remain unclear. Therefore, this cross-sectional study investigated the prevalence of meeting recommended MVPA level and its correlates among Japanese children and adolescents.

METHODS

Using the Japanese version of the World Health Organization (WHO) Health Behaviour in School-aged Children survey questionnaire, we confirmed the prevalence of meeting recommended MVPA level in all primary schools (PS) and junior high schools (JHS) in Unnan City, Japan. We evaluated its association with school grade, gender, body weight status, screen time, consumption of breakfast, physical activity (PA) preference, and population density using Poisson regression.

RESULTS

We found that 20.1% of the 1,794 students (9-15 years old) met the WHO recommendation. Meeting recommended MVPA level was significantly associated with being in the sixth grade of PS (prevalence ratio [PR] 0.57; 95% confidence interval [CI], 0.39-0.84) and first (PR 1.52; 95% CI, 1.16-1.99), second (PR 1.45; 95% CI, 1.10-1.90), and third grade of JHS (PR 0.40; 95% CI, 0.26-0.62) (vs fourth grade of PS); being a boy (PR 1.33; 95% CI, 1.12-1.59) (vs girl); liking PA (PR 3.72; 95% CI, 2.22-6.22) (vs dislike); and belonging to a medium-population-density (PR 0.73; 95% CI, 0.61-0.88) or low-population-density area (PR 0.67; 95% CI, 0.48-0.94) (vs high-population-density area).

CONCLUSIONS

About 20% of Japanese children and adolescents engaged in the recommended MVPA level. MVPA was associated with grade, gender, preference for PA, and population density.

Smartphone Use and Physical Activity among College Students in Health Science-Related Majors in the United States and Thailand

Smartphone use among college students is prevalent across the world. Recently, research has begun to investigate the relationship between smartphone use and physical activity. This study examined the amount of time spent using a smartphone and the physical activity (PA) levels among college students majoring in health science-related disciplines in the United States (US) and Thailand. Using convenience sampling, college students in the US (n = 242) and Thailand (n = 194) completed an online survey, in Fall 2016, assessing smartphone usage and PA. Data were analyzed using chi-square tests and two-way ANOVA (p < 0.05). US students reported more days per week ( U = 15,150.0 , p = 0.00 , r = 0.33 ) and greater duration of PA ( U = 11,234.0 , p = 0.00 , r = 0.33 ) than Thai students while Thai students used smartphones more per day than US students ( U = 13,137.5 , p = 0.00 , r = 0.40 ). No difference existed for years of smartphone use ( U = 22,207.0 , p = 0.27 ). Greater smartphone use per day inversely related to days per week of engaging in PA among Thai students ( X 2 ( 3 ) = 10.55 , p = 0.01 , ε 2 = 0.06 ), but not among US students ( X 2 ( 3 ) = 2.39 , p = 0.50 ). The high smartphone use among college students, especially in Thailand, may be a barrier to PA as well as a strategy for PA promotion in higher education settings. Research should examine the best techniques for smartphone application development to promote PA in college settings.

Regional Socioeconomic Inequalities in Physical Activity and Sedentary Behavior Among Brazilian Adolescents

Background: This study aims to describe the regional prevalence and patterns of physical activity (PA) and sedentary behavior among Brazilian adolescents. Methods: Data from the Brazilian Scholar Health Survey, a nationally representative survey of ninth-grade adolescents [mean age: 14.29 y (14.27–14.29)] conducted in 2015 (n = 101,445), were used. Outcomes were television viewing, sitting time (ST), total PA, and active traveling collected via self-administered questionnaire. Information on frequency of physical education classes and type of school was collected from the school’s director. Frequencies with 95% confidence intervals were used to determine the prevalence and patterns of outcomes. Results: Higher prevalence of PA (≥300 min/wk) and ST (>4 h/d) was found in Midwest (PA = 38.0%; ST = 44.5%), South (PA = 37.6%; ST = 50.1%), and Southeast (PA = 36.1%; ST = 49.3%) compared with Northeast (PA = 29.7%; ST = 36.9%) and North (PA = 34.4%; ST = 34.8%) regions of Brazil. ST was higher among adolescents from private schools (51.5%) than public schools (42.9%), whereas active traveling was greater among students of public schools than private schools (62.0% vs 34.4%). Most inequalities in outcomes between capital and interior cities were in the poorest regions. Conclusions: The results indicate that national plans targeting regional inequalities are needed to improve PA and to reduce sedentary behavior among Brazilian adolescents.