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Caamaño-Navarrete F, Del-Cuerpo I, Arriagada-Hernández C, Alvarez C, Gaya AR, Reuter CP, Delgado-Floody P. Association between Active Commuting and Lifestyle Parameters with Mental Health Problems in Chilean Children and Adolescent. Behav Sci (Basel) 2024; 14:554. [PMID: 39062377 PMCID: PMC11273756 DOI: 10.3390/bs14070554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Little is known about the association between active commuting (i.e., walking or cycling to school) with lifestyle parameters and mental health in youths. The objective of the present study was to investigate the association between mental health problems and symptoms of depression, anxiety, and stress with lifestyle (i.e., food habits, screen time, physical activity, and sleep quality), active commuting, and gender. METHODS A total of 511 children and adolescents (boys, n = 249; girls, n = 262) aged 10 to 17 years participated in the study. Lifestyle parameters and mental health were evaluated using the Depression Anxiety and Stress Scale (DASS-21). RESULTS Girls reported higher levels of anxiety (p = 0.001), depression (p = 0.001), and stress (p = 0.001). Mental health problems showed a positive association with gender (girls, β = 3.06, p < 0.001) and a negative association with food habits (β = -0.65, p = 0.019). Anxiety was positively associated with gender (β = 7.88, p < 0.001) and negatively associated with food habits (β = -0.23, p = 0.019). Gender (girls) and food habits were also associated with symptoms of depression (β = 2.29, p < 0.001 and β = -0.27, p = 0.005, respectively). Finally, active commuting was inversely associated with stress (β = -1.24, p = 0.008), and stress was positively linked to gender (β = 2.53, p < 0.001). CONCLUSIONS Active commuting, lifestyle parameters, and gender were associated with mental health in children and adolescents. Moreover, girls reported higher levels of anxiety, symptoms of depression, and stress.
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Affiliation(s)
- Felipe Caamaño-Navarrete
- Physical Education Career, Universidad Autónoma de Chile, Temuco 4780000, Chile; (F.C.-N.); (C.A.-H.)
| | - Indya Del-Cuerpo
- Department of Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18010 Granada, Spain;
- Strength & Conditioning Laboratory, CTS-642 Research Group, Department Physical Education and Sports, Faculty of Sports Sciences, University of Granada, 18010 Granada, Spain
| | - Carlos Arriagada-Hernández
- Physical Education Career, Universidad Autónoma de Chile, Temuco 4780000, Chile; (F.C.-N.); (C.A.-H.)
- Grupo de Investigación Colaborativa para el Desarrollo Escolar (GICDE), Temuco 4780000, Chile
| | - Cristian Alvarez
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile;
| | - Anelise Reis Gaya
- Graduate Program in Human Movement Sciences, Federal University of Rio Grande do Sul, Porto Alegre 90690-200, Brazil;
| | - Cézane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz do Sul, Independência Av.2293-Universitário, Santa Cruz do Sul 96815-900, Brazil;
| | - Pedro Delgado-Floody
- Department of Physical Education, Sport and Recreation, Universidad de La Frontera, Temuco 4811230, Chile
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Merellano-Navarro E, Godoy-Cumillaf A, Collado-Mateo D, Aguilar-Valdés M, Torres-Mejías J, Almonacid-Fierro A, Valdés-Badilla P, Giakoni-Ramírez F, Bruneau-Chávez J, Olivares PR. Effectiveness of an Ecological Model-Based Active Transport Education Program on Physical and Mental Health in High School Students (MOV-ES Project): Study Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2024; 12:1259. [PMID: 38998794 PMCID: PMC11241461 DOI: 10.3390/healthcare12131259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
The United Nations, through its 2030 Agenda and Sustainable Development Goals, advocates for the establishment of conducive environments for physical activity, following the ecological model. In line with this initiative, active transportation emerges as an accessible, cost-effective, and sustainable approach to augmenting daily physical activity levels. This study protocol endeavors to assess the impact of an active transportation education program rooted in the ecological model on the physical and mental well-being of high school students. Drawing upon scientific insights, we hypothesize that a 16-week active transportation intervention will lead to a 3% reduction in average body fat percentage and a noteworthy enhancement in executive function (including inhibition, cognitive flexibility, and working memory), physical fitness (comprising cardiorespiratory fitness and muscle strength), and mental health (encompassing mood disorders and cognitive functioning). If this intervention proves effective, it could offer a viable solution for the school community, especially in reducing congestion within the school environment. The study protocol aims to evaluate the impact of an active transportation educational program based on the ecological model on the physical and mental well-being of high school students. Three high schools located in the urban area of Talca, Chile, will be randomly selected (one public, one privately subsidized, and one private non-subsidized). Each high school will be randomly assigned an experimental group (n = 30) and a control group (n = 30; without intervention). The experimental groups will receive an active transportation educational intervention during their physical education classes for four months (60 to 90 min sessions, once a week), while the control group will receive no intervention. The primary outcome will provide information on body composition and executive function. Secondary outcomes will include objective physical activity level, physical fitness, mental well-being, academic achievement, health-related quality of life, perception of environmental urban features, physical activity barriers, and adherence to active transportation. It is expected that the results of the MOV-ES Project will transcend the physical health of schoolchildren and will have an impact on the school community, especially by decongesting the school environment.
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Affiliation(s)
- Eugenio Merellano-Navarro
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
| | - Andrés Godoy-Cumillaf
- Grupo de Investigación en Educación Física, Salud y Calidad de Vida (EFISAL), Facultad de Educación, Universidad Autónoma de Chile, Temuco 4780000, Chile
| | - Daniel Collado-Mateo
- Sport Sciences Research Center, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain
| | - Mirko Aguilar-Valdés
- Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
| | - Jorge Torres-Mejías
- Doctoral Program in Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
| | - Alejandro Almonacid-Fierro
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca 3530000, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar 2520000, Chile
| | - Frano Giakoni-Ramírez
- Faculty of Education and Social Sciences, Universidad Andres Bello, Las Condes, Santiago 7550000, Chile
| | - José Bruneau-Chávez
- Departamento de Educación Física, Deportes y Recreación, Universidad de la Frontera, Temuco 4811230, Chile
| | - Pedro R Olivares
- Faculty of Education, Psychology and Sport Sciences, University of Huelva, 21007 Huelva, Spain
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Ding P, Ding C, Feng S. The health benefits of bicycling to school among adolescents in China: A propensity score matching study. Front Public Health 2023; 11:1049254. [PMID: 37081956 PMCID: PMC10110905 DOI: 10.3389/fpubh.2023.1049254] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/14/2023] [Indexed: 04/22/2023] Open
Abstract
Background A large number of high-income countries are now promoting active commuting to school as an opportunity for adolescents to increase physical activity (PA) and improve their health. Few studies have examined the multiple benefits of active travel to school among adolescents in developing countries, especially in China. Hence, this study aims to estimate the effects of bicycling to school on adolescents' subjective health, physical health, and sickness absence. Methods Self-reported and cross-sectional data from 6,353 school-aged children (12-19 years old) in the 2014-2015 China Education Panel Survey (CEPS2014-2015) were used. The independent variable was a binary, self-reported indicator of whether children bicycled to school. The dependent variables included subjective health (self-reported health, mental stress), physical health (BMI, kidney disease, lung disease, heart disease, brain disease, upper limb fracture, lower limb fracture, and sickness frequency), and sickness absence. Propensity score matching (PSM) was used to estimate the causal effects of bicycling to school on adolescents' health. Results Bicycling to school positively affects both subjective and physical health. Those students who biked to school were associated with a higher self-rated health status, a healthier weight, a lower level of mental stress, and a lower risk of developing brain diseases. No significant relation is found between bicycling and sickness frequency, and sickness absence. Moreover, we separately compared the bicycling group with the walking group and the non-active travel group. There is still evidence that cycling is beneficial for students. Compared with walking to school, cycling to school resulted in a higher self-rated health score and a lower mental stress score. Physically, students who bicycled to school were less likely to be absent from school and suffer from kidney and brain diseases than students who walked to school. However, we do not find a significant difference in health outcomes from cycling compared to non-active modes of transportation. Further, differentiation of the health effects of bicycling across living areas shows that health effects are more pronounced for those living in edge and rural areas. Conclusion These findings provide evidence of the value of promoting bicycling to school in improving various adolescents' health outcomes in transitional China.
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Affiliation(s)
- Pengxiang Ding
- School of Public Economics and Administration, Shanghai University of Finance and Economics, Shanghai, China
| | - Chang Ding
- School of Science and Information, Qingdao Agricultural University, Qingdao, China
| | - Suwei Feng
- School of Public Economics and Administration, Shanghai University of Finance and Economics, Shanghai, China
- *Correspondence: Suwei Feng,
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Ding P, Feng S. How School Travel Affects Children's Psychological Well-Being and Academic Achievement in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13881. [PMID: 36360761 PMCID: PMC9658989 DOI: 10.3390/ijerph192113881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
Previous research on the role of school travel in children's well-being (WB) has paid little attention to developing countries. Using national survey data across China, this study examines how children's psychological well-being (PWB) and academic performance differ across commute duration and mode among urban, rural, and urban fringe areas. Our findings show that commute times are significantly negatively associated with children's PWB and academic achievements, and this correlation varies across areas. Children living in the urban fringe have the longest average one-way commuting time (18.6 min), but they have a better acceptance of longer commuting duration, whereas commuting time is more influential in the city center and rural areas. Regarding travel mode, walking to school is positively associated with PWB in the center area, while bicycles and public transport positively affect the rural student scores. Results from quantile regression show that students on the lower quantiles of the conditional distribution of PWB tend to suffer more than the others when commuting time increases; students with middle scores respond similarly to marginal changes in commuting time. Recommendations for urban planners and policymakers to enhance child WB include fostering school-home balance, improving public transit services, and investing in pedestrian and bicycle infrastructure for those vulnerable groups.
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Time Trends of Step-Determined Physical Activity Among Adolescents With Different Activity Levels in Czech Republic. J Phys Act Health 2022; 19:592-598. [PMID: 35940579 DOI: 10.1123/jpah.2022-0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/20/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study aimed to present step-determined physical activity trends in adolescents with different activity levels over a period of 10 years. METHODS Pedometers were used to monitor weekly physical activity in 1855 boys and 2648 girls aged 15-19 years recruited from 155 schools in the Czech Republic between 2009 and 2018. Trends for average steps/day and percent of accumulating various levels of steps/day (<10,000, 10,000-13,000, and >13,000 steps/d) were analyzed by sex. RESULTS There was a statistically significant decrease in average steps/day between 2009-2010 and 2017-2018 in boys from 12,355 (3936) steps/d to 10,054 (3730) steps/d and girls from 11,501 (3278) steps/d to 10,216 (3288) steps/d. The percent accumulating <10,000 steps/d increased by 21% in boys and 12% in girls. The percent achieving >13,000 steps/d decreased by 17% in boys and 10% in girls. CONCLUSIONS Objectively collected evidence indicates an overall decrease in Czech adolescents' steps/day over a 10-year period concurrent with an increase in the percent of boys and girls accumulating <10,000 steps/d. These trends are concerning as they portend a decline in physical activity as adolescents transition to adulthood and continue to age, which also may have major health implications.
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Differences and Associations between Physical Activity Motives and Types of Physical Activity among Adolescent Boys and Girls. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6305204. [PMID: 35686232 PMCID: PMC9173893 DOI: 10.1155/2022/6305204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/06/2022] [Indexed: 12/14/2022]
Abstract
Interventions aimed at motivation for physical activity (PA) are mostly beneficial, but the effects on preventing the decrease in PA are not entirely clear, especially in girls. The main aim of this study was to identify the differences and associations between PA motives and types of PA in boys and girls and between low and high motivated boys and girls. Another aim is to identify the types of motivation and PA that increase the likelihood of achieving PA recommendations and to propose ways of increasing PA among low motivated adolescents. The research carried out before the COVID-19 pandemic (2010–2019) and involved 2,149 Czech and 1,927 Polish adolescents aged 15–19 years. The International Physical Activity Questionnaire-Long Form was used to identify the level of PA types, while PA motivation was examined through the Motives for Physical Activities Measure-Revised. During the ten years, a decline was observed in enjoyment, fitness, and social motives. An increase in appearance motives was observed in girls, while no significant changes were seen in boys. Boys showed a higher motivation for PA than girls in enjoyment, competence, fitness, and social motives, while girls were high motivated in appearance motives. The greatest statistically significant differences between low and high motivated individuals were found in the associations between recreation/vigorous PA and between all types of motivation in boys and girls in both countries. The strongest associations in both genders were observed between enjoyment/competence motives and recreation/vigorous PA. Respecting and using the associations between the types of PA motives and types of PA in low and high motivated boys and girls can support feelings of PA enjoyment, increase PA, support the achievement of PA recommendations, and positively affect adolescents' healthy lifestyles.
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Materová E, Pelclová J, Gába A, Frömel K. Surveillance of physical activity and sedentary behaviour in czech children and adolescents: a scoping review of the literature from the past two decades. BMC Public Health 2022; 22:363. [PMID: 35189870 PMCID: PMC8859875 DOI: 10.1186/s12889-022-12766-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND This study aimed to map the available evidence related to physical activity (PA) and sedentary behaviour (SB) in Czech children and adolescents and suggest future directions and improvements to strengthen the surveillance of PA and SB in the Czech Republic. METHODS The search of articles published between January 2000 and December 2020 included the Medline and Medvik databases and a manual search in eight Czech journals related to the topic. This review followed the "Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews". RESULTS Out of 350 identified articles, 79 articles met the criteria for selection and referred to 27 studies. The majority of the articles were cross-sectional (89%), approximately two-thirds of the articles (61%) examined only PA, and half of the articles (51%) employed device-based assessments. Approximately 47% of the articles reported the prevalence of physical inactivity on the basis of inconsistently defined recommendations. Approximately 14%, 23%, and 10% of the articles focused on active transportation, organized PA (including physical education or leisure-time PA), and parent-child PA, respectively. CONCLUSIONS Future studies need to focus on longitudinal design and interventions, randomly selected samples, a mix of device-based and self-reported methods, and the recognition of health-related 24-hour time use patterns. This review advocates the government-supported development of a national surveillance system that will help to reduce insufficient PA and excessive SB.
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Affiliation(s)
- Eliška Materová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Jana Pelclová
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Aleš Gába
- Department of Natural Sciences in Kinathropology, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
| | - Karel Frömel
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11 Olomouc, Czech Republic
- Institute of Sport Sciences, the Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Does Vigorous Physical Activity Contribute to Adolescent Life Satisfaction? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052236. [PMID: 33668269 PMCID: PMC7956582 DOI: 10.3390/ijerph18052236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/23/2021] [Accepted: 02/19/2021] [Indexed: 12/14/2022]
Abstract
Background: Physical and mental health are the basis of life satisfaction (LS), even during adolescence. The aim of this study was to identify the associations between LS and types of physical activity (PA) in Czech and Polish boys and girls. Methods: The research involved 933 girls and 663 boys aged 15–19 years. LS was diagnosed using the Bern Subjective Well-Being Questionnaire and the WHO-5 Well-Being Index. The International Physical Activity Questionnaire-long form (IPAQ-LF) questionnaire was used to identify the types of weekly PA. Results: Adolescents with the highest LS had more recreational, moderate, vigorous, and total weekly PA. The strongest associations between LS and PA were in the Czech and Polish boys and girls who participated in vigorous PA (VPA). The recommendations for VPA were fulfilled by 45% of Czech and 46% of Polish boys and 40% of Czech and 50% of Polish girls, with the highest LS. The most significant positive moderator between LS and PA was participation in organized PA. Boys with the highest LS were 1.94 times more likely to meet the weekly recommendation of VPA than boys with the lowest LS. Similarly, girls with the highest LS were 1.77 times more likely to meet these recommendations. Conclusions: Promoting both current subjective well-being and organized PA, with an emphasis on achieving the VPA recommendations, may support general LS and a healthy lifestyle in adolescents.
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Rahman ML, Pocock T, Moore A, Mandic S. Active Transport to School and School Neighbourhood Built Environment across Urbanisation Settings in Otago, New Zealand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239013. [PMID: 33287302 PMCID: PMC7729771 DOI: 10.3390/ijerph17239013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022]
Abstract
The school neighbourhood built environment (BE) can facilitate active transport to school (ATS) in adolescents. Most previous studies examining ATS were conducted in large urban centres and focused on BE of home neighbourhoods. This study examined correlations between school-level ATS rates among adolescents, objectively measured school neighbourhood BE features, and adolescents’ perceptions of the school route across different urbanisation settings. Adolescents (n = 1260; 15.2 ± 1.4 years; 43.6% male) were recruited from 23 high schools located in large, medium, and small urban areas, and rural settings in Otago, New Zealand. Adolescents completed an online survey. School neighbourhood BE features were analysed using Geographic Information Systems. School neighbourhood intersection density, residential density and walkability index were higher in large urban areas compared to other urbanisation settings. School-level ATS rates (mean 38.1%; range: 27.8%–43.9%) were negatively correlated with school neighbourhood intersection density (r = −0.58), residential density (r = −0.60), and walkability index (r = −0.64; all p < 0.01). School-level ATS rates were also negatively associated with adolescents’ perceived safety concerns for walking (r = −0.76) and cycling (r = −0.78) to school, high traffic volume (r = −0.82), and presence of dangerous intersections (r = −0.75; all p < 0.01). Future initiatives to encourage ATS should focus on school neighbourhood BE features and minimise adolescents’ traffic safety related concerns.
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Affiliation(s)
- Mohammad Lutfur Rahman
- Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin 9054, New Zealand;
- Correspondence: ; Tel.: +64-3-479-9112
| | - Tessa Pocock
- Faculty of Medical and Health Sciences, School of Nursing, The University of Auckland, Auckland 1142, New Zealand;
| | - Antoni Moore
- School of Surveying, University of Otago, Dunedin 9054, New Zealand;
| | - Sandra Mandic
- Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin 9054, New Zealand;
- Centre for Sustainability, University of Otago, Dunedin 9054, New Zealand
- Faculty of Health and Environmental Sciences, School of Sport and Recreation, Auckland University of Technology, Auckland 1142, New Zealand
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Secular Trends in the Achievement of Physical Activity Guidelines: Indicator of Sustainability of Healthy Lifestyle in Czech Adolescents. SUSTAINABILITY 2020. [DOI: 10.3390/su12125183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
(1) Background: The increasing socio-economic and educational demands on adolescents should be reflected in their lifestyles accordingly. The aim of the study was therefore to identify the trends in the achievement of physical activity (PA) guidelines by Czech adolescents through objective and subjective PA monitoring. (2) Methods: The research was carried out between 2010 and 2017 and involved 49 secondary schools, 2 higher vocational schools, and 8 universities in the Czech Republic. In total, the projects involved 1129 girls and 779 boys. PA monitoring was performed by Yamax SW-700 pedometers and IPAQ-long questionnaires. (3) Results: The results according to the average number of steps/day confirm a decrease in the amount of PA in boys and girls and in the achievement of the recommended 11,000 steps/day. However, the estimates of meeting the recommended weekly PA expressed as MET-min/week based on the IPAQ-long questionnaire are not so convincing about the decrease. (4) Conclusions: The combination of objective monitoring of weekly PA using wearables and subjective estimates of weekly PA using a questionnaire regarding the ease of application, appears to be a sufficient indicator of the status of and trend in PA and thus the sustainability of a healthy lifestyle in youths.
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