Factors That Influence Participation in Physical Activity in School-Aged Children and Adolescents: A Systematic Review from the Social Ecological Model Perspective

Physical Activity Monitoring in Children in the 1-Year After 3 or More Days of Invasive Ventilation: Feasibility of Using Accelerometers

OBJECTIVES

To measure physical activity in a cohort of children who survived greater than or equal to 3 days of invasive ventilation.

DESIGN

Prospective cohort study (2018-2021).

SETTING

Quaternary children's hospital PICU.

PATIENTS

Children (2-17 yr old) without a preexisting tracheostomy who were ambulatory pre-illness and received greater than or equal to 3 days of invasive ventilation.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

We measured duration and intensity of physical activity using hip- (< 6 yr old) or wrist- (≥ 6 yr old) worn ActiGraph GT3XP-BTLE accelerometers (ActiGraph, Pensacola, FL) for 7 days at three timepoints: hospital discharge, 3 months, and 12 months post-discharge. We measured duration of moderate or vigorous physical activity (MVPA) and nonsedentary activity, both characterized as percent of total awake wear time and total minutes per day. We categorized participants based on when they first attained a "high activity" day defined as greater than or equal to 60 minutes of MVPA or a day with percent of MVPA in the top quartile of all days measured. We evaluated 55 children of whom 43 (78%) had data from greater than or equal to 1 timepoint including 19 (35%) with data from all timepoints. Maximum daily MVPA increased across the three post-discharge timepoints (median, 16.0 min [interquartile range (IQR), 8.0-42.8 min], 48.3 min [27.8-94.3 min], and 68.4 min [34.7-111.0 min], respectively) as did maximum daily percent of awake wear time in MVPA (median, 4.3% [IQR, 2.8-9.0%], 10.1% [5.7-14.4%], and 11.1% [7.1-17.5%], respectively). Of the 43 participants, 27 achieved a high activity day: nine of 43 during the hospital discharge period, 14 of 43 during the 3 months post-discharge period, and four of 43 during the 12 months post-discharge period; 16 of 43 did not demonstrate high activity during the post-discharge year.

CONCLUSIONS

In the 1-year after PICU discharge measuring physical activity with accelerometers in children 2-17 years old is feasible. Furthermore, demonstration of variable recovery trajectories in our pilot cohort suggests it has potential to be an outcome measure in clinical trials.

Factors that influence participation in physical activity in Chinese teenagers: perspective of school educators and parents in respect of the social ecology model

Introduction

The objective of this study was to explore the viewpoints of parents, teachers, and administrators on the factors influencing adolescent physical activity in China.

Methods

The study employed semi-structured interviews with school teachers, school principals, government officers, and parents. Twenty-five participants were recruited from Jiangsu Province, China, and completed the interview.

Results

The data collected were analysed using grounded theory within the social ecology model framework. The analysis identified 49 concepts across 19 subcategories and five main categories.

Discussion

The resulting theoretical model, constructed using grounded theory, integrated five main categories: individual factors, family environment, school environment, community environment, and policy. This model provides a foundational understanding of the multifaceted influencing factors of adolescent physical activity in China.

A person-centered approach to cognitive performance analysis in primary school children: Comparisons through self-organizing maps

The objective of this study was to identify distinct student profiles based on physical, psychological, and social characteristics, and examine their impact on cognitive performance. A total of 194 children participated in this cross-sectional design study (mean age = 10.61 years, SD = 0.45; 48.96% girls). The study included participants from diverse racial backgrounds. Using Self-Organizing Maps, an unsupervised neural network clustering technique, six distinct profiles were identified. These profiles revealed significant effects in daily physical activity, self-reported physical, social, and psychological factors, and physical performance. Profiles characterized by higher physical activity levels and positive social and psychological factors were associated with better cognitive performance, in contrast to profiles with lower levels in these domains. These findings suggest that students' cognitive outcomes may be linked to their physical, psychological, and social characteristics, which interact to shape cognitive functioning. The recognition of the diversity of student profiles in specific educational settings may facilitate the design of more targeted programs that address individual needs and strengths, thereby enhancing their development in these domains within similar educational contexts.

A configurational path study of adolescents' intention to participate in ice and snow sports based on the TPB and NAM frameworks

The development of ice and snow sports is a crucial aspect of building China into a leading sports nation. Enhancing adolescents' willingness to participate in ice and snow sports reflects the essence of sustainable and high-quality development in this field. Using data from 23 provinces and municipalities in China in 2023, this study adopts an integrated theoretical framework combining the Theory of Planned Behavior (TPB) and the Norm Activation Model (NAM). Employing fuzzy-set qualitative comparative analysis (fsQCA), the study identifies key influencing factors and explores the configuration paths affecting adolescents' willingness to participate in ice and snow sports. The findings are as follows: (1) Although public participation in ice and snow sports among adolescents is being actively promoted in China, there remains a lack of comprehensive understanding of their participation intentions and demands. (2) Subjective norms and personal norms, as sufficient conditions, show strong explanatory power in shaping adolescents' willingness to participate in ice and snow sports. This highlights the importance of exploring multiple condition-variable configurations to gain a more comprehensive and in-depth understanding of adolescents' participation intentions. (3) Four primary paths to promoting adolescents' willingness to participate in ice and snow sports were identified: the comprehensive driver path (C1), the emotional and normative resonance path (C2), the integrated participation path (C3), and the knowledge-behavior co-driven paths (C4 and C5). The study recommends a collaborative approach between government and schools to integrate ice and snow sports into adolescents' quality education system, leveraging digital technologies to enrich and enhance their ice and snow sports experience. Additionally, fostering an ice and snow culture to strengthen adolescents' emotional identity and cultural value perception of these sports is essential to attract more youth participation. By focusing on the integrated TPB-NAM theoretical framework and incorporating risk perception and prior knowledge for evaluating participation willingness, this study effectively overcomes the limitations of single-method approaches. This expansion provides new perspectives and proposes novel paths, such as emotional and normative resonance and knowledge-behavior co-driving, for understanding and promoting ice and snow sports. These findings offer targeted market insights and intervention strategies for policymakers and practitioners. The fsQCA method identifies key drivers and contextual combinations, assisting policymakers, educators, and learners in promoting participation. Overall, this study enriches theoretical understanding and proposes comprehensive and scenario-adaptive dynamic paths to foster high-quality development in ice and snow sports while providing practical guidance for policymakers and educators.

The Childhood Opportunity Index 2.0: Factor Structure in 9-10 Year Olds in the Adolescent Brain Cognitive Development Study

The built physical and social environments are critical drivers of child neural and cognitive development. This study aimed to identify the factor structure and correlates of 29 environmental, education, and socioeconomic indicators of neighborhood resources as measured by the Child Opportunity Index 2.0 (COI 2.0) in a sample of youths aged 9-10 enrolled in the Adolescent Brain Cognitive Development (ABCD) Study. This study used the baseline data of the ABCD Study (n = 9767, ages 9-10). We used structural equation modeling to investigate the factor structure of neighborhood variables (e.g., indicators of neighborhood quality including access to early child education, health insurance, walkability). We externally validated these factors with measures of psychopathology, impulsivity, and behavioral activation and inhibition. Exploratory factor analyses identified four factors: Neighborhood Enrichment, Socioeconomic Attainment, Child Education, and Poverty Level. Socioeconomic Attainment and Child Education were associated with overall reduced impulsivity and the behavioral activation system, whereas increased Poverty Level was associated with increased externalizing symptoms, an increased behavioral activation system, and increased aspects of impulsivity. Distinct dimensions of neighborhood opportunity were differentially associated with aspects of psychopathology, impulsivity, and behavioral approach, suggesting that neighborhood opportunity may have a unique impact on neurodevelopment and cognition. This study can help to inform future public health efforts and policy about improving built and natural environmental structures that may aid in supporting emotional development and downstream behaviors.

Enhancing physical activity levels in 9-11-year-old children of varied genders: strategies leveraging parental exercise consciousness

Objective

This study aimed to explore the predictive associations of parental exercise consciousness with the physical activity (PA) status and characteristics of 9-11-year-old children, in an attempt to identify effective strategies for addressing PA insufficiency in children from a parental standpoint.

Methods

The PA rating scale-3 and the Chinese Civic Exercise Consciousness Questionnaire were used to measure primary school students' PA and their parents' exercise consciousness from 361 families in Tianjin, China. The dimensions of exercise consciousness were cognition and identity (CI), sentiment and intention (SI), attitude and willingness (AW), and rights and responsibilities (RR) dimensions. Descriptive statistics, ANOVA with post-hoc test analysis, correlation analysis, and hierarchical regression analysis were performed.

Results

First, children's PA increased with age, with boys significantly exceeding girls (p < 0.01). Significant gender differences were observed in both PA intensity and frequency (boys higher than girls, p < 0.01), although this was not consistent across age groups. Variations in PA duration and frequency showed significant age-related changes (p < 0.01), whereas intensity showed significant changes at older ages (p < 0.01). Second, we observed moderate to above-average level of parental exercise consciousness, and a significantly positive correlation between parental exercise consciousness and children's PA levels (α = 0.601, p < 0.01); meanwhile, all four dimensions of parental exercise consciousness showed varying degrees of positive correlations with children's PA intensity, duration, and frequency (p < 0.01). Third, stratified linear regression analysis showed the varied predictive associations of the different dimensions of parental exercise consciousness with children's PA intensity, duration, and frequency. SI and AW significantly predictively associated with PA levels across different age groups and genders (p < 0.05).

Conclusion

Age and gender showed crucial associations with children's PA levels, resulting in distinct preferences and behaviors between boys and girls across various age groups. Parental exercise consciousness of exercise positively associated with the intensity, frequency, and overall volume of children's PA. Enhancing parental consciousness of exercise-related emotions, intentions, attitudes, and willingness may effectively associate with enhancements in the intensity, duration, and frequency of their children's PA, ultimately promoting greater engagement in physical exercise among the youth.

Exploration of motivation to be physically active among overweight adolescents in Switzerland

Motivation plays an important role in the field of medicine, as it significantly influences behavior change, such as becoming more physically active. This study aimed to investigate the role of motivation in engagement in a physical activity and its impact on quality of life for adolescents suffering from obesity. We assessed the time dedicated to physical activities, the type of motivation, and the relationship between those factors and their quality of life. Seventy-two adolescents aged 12-18 years (51% girls) participated in the study. Fifteen percent of the sample (11/72) were overweight, 56% (n = 40) were affected by obesity and 29% (n = 21) by severe obesity. We found that adolescents were mostly driven to engage in physical activity by self-determined motivation, but those affected by severe obesity were more motivated by external factors. Moreover, there was a disparity in physical activity engagement between genders, with boys being more active than girls. Finally, our data demonstrated that physical exercise contributed to improving quality of life of our population. This study demonstrates that self-determined motivation plays a significant role in promoting physical activity among adolescents with overweight or obesity, with notable differences between genders. Encouraging intrinsic motivation can improve physical functioning and quality of life.

Applying intervention mapping to develop a program for promoting short physical activity breaks during class time in upper secondary schools: the MOVE12 protocol study

Introduction

Physical inactivity is a global health challenge, exacerbated by increased screen time and sedentary behaviors. Enhancing physical activity levels at schools offers a promising approach to promote lifelong healthy habits.

Methods

This protocol paper outlines the MOVE12 pilot study, a 12-week intervention study designed to increase physical activity among Norwegian upper secondary school students through 6-7-min daily MOVE-breaks integrated into lessons. Developed using the six-phase Intervention Mapping (IM) protocol, grounded in the social-ecological model and self-determination theory, the intervention focuses on fostering motivation and creating a supportive environment. Key steps include needs assessment, performance objectives, theoretical methods, and program structuring for sustainability.

Results

Linear mixed models, t-tests, and regression analyses will evaluate quantitative outcomes, while qualitative focus groups will explore engagement and behavior change.

Discussion

MOVE12 provides insights into scalable school-based interventions addressing physical inactivity, highlighting the potential of the IM framework to establish sustainable health promotion strategies.

Exploring the associations of perceived physical literacy with depression, anxiety, and stress among Spanish adolescents

BACKGROUND AND PURPOSE

The concept of physical literacy has gained prominence in the context of adolescent health, with increasing evidence suggesting its potential as a pivotal factor in promoting adolescent well-being and physical activity. The objective of the current study was to examine the relationships between perceived physical literacy (PPL) and symptoms of depression, anxiety, and stress in Spanish adolescents.

MATERIALS AND METHODS

A cross-sectional study including 714 adolescents was conducted. The Spanish Perceived Physical Literacy Instrument for Adolescents (S-PPLI) and Depression Anxiety Stress Scale 21 (DASS-21) were used. To determine the relationship between the PPL and DASS-21 score, robust linear regression models were constructed.

RESULTS

After adjusting for several covariates, an inverse relationship was found between the S-PPLI score and the domains of the DASS-21 (symptoms of depression: unstandardized beta coefficient [B] = -0.14; 95 % confidence interval [CI] -0.20 to -0.08; p < 0.001; anxiety: B = -0.09; 95 % CI -0.15 to -0.04; p = 0.002; and stress: B = -0.09; 95 % CI -0.16 to -0.03; p = 0.006). Furthermore, adolescents with high PPL status presented significantly lower symptoms of depression, anxiety and stress than adolescents with low PPL status did.

CONCLUSION

PPL could be considered a key factor in preventing the development of symptoms of depression, anxiety, and stress in the adolescent population. Physical literacy might play a decisive role in the potential of physical activity in promoting mental health in adolescents.

Family and Home Environment Predictors of Children's 24-Hour Movement Guideline Adherence: A Mixed-Methods Study

Background: During summer, children may meet fewer 24 hours Movement Guidelines (24 hr-MGs) [moderate-vigorous physical activity (PA): ≥60 minutes/day, screen time: ≤2 hours/day, sleep: 9-11 hours/day) compared with the school year. Structured environments within community settings (e.g., summer programs) support guideline adherence. Information about the relationship between structured home environments and 24 hr-MGs is needed. This mixed-methods study examined which features of the family, home, and community environment supported children in meeting 24 hr-MGs during the school year and summer. Methods: Children's PA and sleep data were estimated from wrist-worn accelerometry, and screen time was assessed via parent-reported nightly surveys (14 days) at two time points [school year: (March-April) and summer (July-August) of 2021]. Parents completed a survey at each time point with 13 measures of the family (e.g., screen time rules), home (e.g., bed sharing), and community (e.g., summer program enrollment) environment. Multilevel mixed effect logistic regression estimated the odds of meeting 24 hr-MGs at each time point. Parents (n = 20) completed a qualitative interview and thematic analysis revealed parents perceived facilitators and barriers to guideline adherence. Results: Summer program enrollment and bedtime rules were associated with greater odds of meeting the PA [odds ratios (ORs): 4.9, 95% confidence intervals (CIs): (1.4, 17.1)] and ≥two 24 hr-MGs [OR: 2.2, 95 CI: (1.2, 4.0)] during summer, respectively. Parents perceived family rules/routines supported guideline adherence and lack of access to summer programs was a barrier. Conclusions: Structured environments at home and in the community can support children in meeting 24 hr-MGs guidelines. Interventions that expand access to summer programming and encourage implementation of structured home routines may support meeting multiple 24 hr-MGs during summer.

Health-related physical fitness in children among five Mediterranean countries: a cross-cultural study from the DELICIOUS project

Background

Health-related fitness (HRF) components are essential for supporting healthy growth and reducing long-term health risks in children. This study explored cross-cultural variations in HRF among children from five Mediterranean countries-Egypt, Italy, Lebanon, Portugal, and Spain-within the framework of the DELICIOUS project.

Methods

A total of 860 children participated in the study, including 204 from Egypt (n = 204, 11.72 ± 1.46 years), 150 from Italy (9.66 ± 1.10 years), 200 from Lebanon (10.73 ± 1.90 years), 181 from Portugal (11.04 ± 1.83 years), and 125 from Spain (12.33 ± 2.27 years). Participants completed the International Physical Performance Test Profile (IPPTP), which assesses sprint speed (20 m dash), coordination (jumping sideways), upper body strength (push-ups), abdominal strength (sit-ups), lower body power (standing long jump), and cardiovascular endurance (6-min run). Children were categorized into two age groups: 8-10 and 11-14 years. ANCOVA, adjusting for BMI, was performed to analyze differences across countries and age groups.

Results

Analysis revealed significant differences in HRF across countries and age groups (p < 0.05). Spanish boys and girls consistently demonstrated superior sprint performance (20 m dash) and cardiovascular endurance (6-min run) compared to peers from other countries. Lebanese and Spanish girls exhibited stronger abdominal performance (sit-ups) than Egyptian girls, while Spanish girls also excelled in lower-body power (standing long jump). These findings underscore cross-cultural variations in HRF outcomes among Mediterranean children.

Conclusion

Cross-cultural differences in physical education programs and sports participation appear to influence HRF in children across the Mediterranean region. These findings underscore the need for culturally tailored physical education strategies and public health initiatives to ensure balanced fitness development in diverse cultural populations.

School-based factors influencing physical activity participation in children and adolescents with disabilities: A qualitative systematic review and meta-synthesis

BACKGROUND

Children and adolescents with disabilities (CAD) frequently encounter barriers to participation in physical activity (PA). Schools play a vital role in promoting PA, making it crucial to understand the school-based factors influencing CAD's PA participation.

OBJECTIVE

This qualitative systematic review and meta-synthesis aims to identify and elucidate the school-based factors influencing PA engagement among this population.

METHODS

A comprehensive search across six databases-Web of Science, PsycINFO, Scopus, SPORTDiscus, and Embase, CNKI-was conducted in August 2023, and subsequently updated in April 2024. English or Chinese peer-reviewed journal articles that contained substantial qualitative data regarding school-based factors affecting PA in CAD were included. The methodological quality of included studies was evaluated utilizing the Critical Appraisal Skills Program Qualitative Checklist. Qualitative data were analyzed through thematic synthesis.

RESULTS

A total of 16 studies (12 qualitative studies and 4 mixed-methods studies) were included, all of which were of moderate to high quality. Thematic synthesis identified four major themes: (a) physical environment (provision of facilities, specialized and adapted equipment, space for activities); (b) social environment (peers, school leaders, teachers and other school staff); (c) opportunities for PA (physical education, classroom movement integration, extra-curricular activities); and (d) characteristics of PA (adaption of rules and task difficulty, competition components, diversified activities, fun).

CONCLUSIONS

This review reveals the complex interplay of different school-based factors affecting PA participation among CAD. The findings provide valuable insights for educators, policymakers, and health professionals to enhance PA participation in this population.

Exploring Adolescent Moderate-to-Vigorous Physical Activity in China: Mediating Roles of School Climate, Perceived Barriers, and Physical Education Satisfaction

Background

The lack of physical activity poses a major challenge to adolescents' healthy physical and mental development. Despite growing attention, research on how the school physical activity climate affects Chinese adolescents' participation in moderate-to-vigorous physical activity (MVPA) remains scarce. This study explores this relationship through the lens of ecological systems theory, focusing on the mediating roles of physical education satisfaction and perceived barriers. It also proposes strategies to promote MVPA among Chinese adolescents.

Methods

This cross-sectional study employed convenience and snowball sampling methods to examine the impact of the school physical activity climate on adolescent participation in MVPA. It also explored the mediating roles of physical education satisfaction and perceived barriers. Four variables in the study were measured using established scales: Physical Activity Climate, Perceived Barriers to Physical Activity, Physical Education Satisfaction, and Physical Activity Assessment. The data were analyzed using AMOS v.23 to construct and test a structural equation model.

Results

A total of 612 adolescents aged 12 to 18 from six key middle schools in central China participated in the study. The findings showed that a positive school physical activity climate significantly promotes MVPA participation. Physical education satisfaction positively correlated with MVPA (β = 0.322, p < 0.001), while perceived barriers negatively correlated with both physical education satisfaction (β = -0.449, p < 0.001) and MVPA (β = -0.366, p < 0.001). Satisfaction with physical education and perceived barriers mediated the relationship between the school climate and MVPA, emphasizing their importance in shaping adolescent physical activity behavior. Confirmatory factor analysis (CFA) results (χ²/df = 1.928, GFI = 0.969, AGFI = 0.956, NFI = 0.962, CFI = 0.981, RMSEA = 0.037) confirmed the model's robustness and good fit.

Conclusion

Adolescents in a positive physical activity climate are more likely to overlook perceived barriers, enjoy higher satisfaction in PE classes, and actively engage in MVPA. Schools and educators are advised to foster a supportive physical activity environment to boost adolescent MVPA participation, considering the unique context of China's educational system.

DE-PASS Best Evidence Statement (BESt): Determinants of self-report physical activity and sedentary behaviours in children in settings: A systematic review and meta-analyses

Previous physical activity interventions for children (5-12yrs) have aimed to change determinants associated with self-report physical activity behaviour (PAB) and/or sedentary behaviour (SB), however, the associations between these determinants and PAB/SB in different settings are uncertain. The present study aimed to identify modifiable determinants targeted in previous PAB/SB interventions for children. Intervention effects on the determinants and their associations with self-report PAB/SB were assessed across settings. Search of relevant interventions from pre-defined databases was conducted up to July 2023. Randomized and non-randomized controlled trials with modifiable determinants were included. Data extraction and risk of bias assessments were conducted by two independent researchers. Where data could be pooled, we performed Robust Bayesian meta-analyses. Heterogeneity, publication bias and certainty of evidence were assessed. Fifteen studies were deemed eligible to be included. Thirty-seven unique determinants within four settings were identified-school, family, school with family/home, and community with(out) other settings. Ninety-eight percent of determinants belonged to individual/interpersonal determinant categories. Narratively, intervention effects on student perception of teachers' behaviour (school), self-management, perceived barriers, external motivation, exercise intention, parental modeling on SB (school with family/home) and MVPA expectations (community) were weak to strong, however, corresponding PAB/SB change was not evident. There were negligible effects for all other determinants and the corresponding PAB/SB. Meta-analyses on self-efficacy, attitude, subjective norm and parental practice and PAB/SB in two settings showed weak to strong evidence against intervention effect, while the effect on knowledge could not be determined. Similarly, publication bias and heterogeneity for most analyses could not be ascertained. We found no concrete evidence of association between the modifiable determinants and self-report PAB/SB in any settings. This is presumably due to intervention ineffectiveness. Design of future interventions should consider to follow the systems-based approach and identify determinants unique to the context of a setting, including policy and environmental determinants.

Effects of a 12-Week Physical Activity Intervention on Psychological Symptoms in Adolescents

Participation in regular physical activity (PA) is associated with numerous health benefits, including improvement in adolescents' mental health. The current study aimed to assess the effects of a 12-week physical activity intervention on psychological symptoms of adolescents. The sample of this controlled randomized study was composed by 150 adolescents aged 12 to 15 years old. PA intervention is an adaptation of the ActTeens Program, which includes structured PA sessions delivered during Physical Education classes. The Strengths and Difficulties Questionnaire (SDQ) was used to measure psychological symptoms. To analyze the effects of the intervention on psychological symptoms, generalized estimating equations (GEEs) models were constructed. After 12 weeks, there were no significant intervention effects for emotional problems (mean difference: -0.14; 95% IC: -1.1-0.82), conduct problems (mean difference: 0.14; 95% IC: -0.6-0.8), attention deficit/hyperactivity disorder (mean difference: -0.66; 95% IC: -1.4-0.1), peer problems (mean difference: 0.2; 95% IC: -0.6-1.0), prosocial behavior (mean difference: 0.00; 95% IC: -0.8; 0.8) and overall mental health score (mean difference: 0.15; 95% IC: -2.0; 2.3). No improvement in psychological symptoms was observed after 12 weeks of PA intervention. Future studies should explore how PA in different dimensions and contexts may impact positively on adolescents' mental health.

Identifying data gaps in early childhood physical activity evidence

Childhood physical activity sets the foundation for health. While we know many factors that contribute to physical activity, there are limitations in our knowledge, especially in early childhood. Through our review, we identify gaps in existing datasets to guide future research.

Profiles of Primary School Children's Sports Participation and Their Motor Competencies

BACKGROUND/OBJECTIVES

Children participate in various organized and informal physical activities (PAs) in their leisure time, presenting diverse objectives and environments for motor and social development. However, current research often focuses on specific, mostly organized activities, overlooking the complexity of participation across different settings. This study aimed to (1) identify groups of children with similar characteristics based on their participation in five organized and informal sports activities and (2) examine how the groups differ regarding gender, age, BMI, motor competencies (MCs), and attendance in institutionalized care at school.

METHODS

The study included n = 1717 1st and 2nd graders (M = 7.60 years, SD = 0.59, 50.7% girls) and n = 1319 3rd and 4th graders (M = 9.46 years, SD = 0.57, 49.4% girls) from the "EMOKK" study, funded by the Swiss National Science Foundation. Data were collected via parent questionnaires on leisure sports participation, and MCs were assessed using MOBAK-1-2 and 3-4 tests. Latent profile analyses (LPAs) and univariate ANOVAs were used to identify group differences.

RESULTS

A three-profile LPA model best fits the data, revealing differences in participation across individual and team sports, optional school sports, free play on the school playground, and informal activities during leisure time. Children involved more in team sports (profiles: allrounder and very active sportsperson) participate more in informal play and present better MCs than children participating mainly in individual sports (profile: individual sportsperson). Girls were predominantly in the individual sports profile, while boys were more evenly spread across all groups. These findings highlight the importance of designing targeted interventions that promote participation in both organized and informal sports, particularly for children with lower levels of PA.

CONCLUSIONS

Children show different patterns of engagement in different interrelated organized and informal leisure PA contexts. These specific patterns and the children's MCs should be taken into account for the targeted promotion of PAs during leisure time.

"I Use Technologies Strategically With My Family Now": Practices That Parents Value to Promote Physical Activity in Young Children

BACKGROUND

Although widely accessible digital technology (DT) provided multiple opportunities for young children's play, learning, and development, it also raised parents and professionals' concerns regarding its impact on children's physical activity. This study aimed to identify practices involving DT that were valued by parents in helping their young child to be physically active.

METHODS

Participants were parents of ambulatory young children (less than 5 y of age) engaged with a playgroup. The study involved representatives from 3 service organizations, who compiled a list of digital resources related to using DT to promote children's physical activity that were suitable to be shared and trialed by parents and young children. During a pretrial workshop, researchers, participants, and organization representatives collaboratively developed the intervention, which involved the delivery of selected resources by weekly email, over a 12-week period. Participants provided weekly feedback about their experiences and participated in a postintervention semistructured qualitative interview.

RESULTS

Thirteen families, with children aged between 15 and 36 months, completed the trial. Participants reported several valued practices to promote their children's physical activity, including those where the child was active while engaging with DT, where child engagement with DT acted as a prompt for later physical activity, where DT assisted parents in planning physical activity, where DT assisted parents in integrating movement with learning and play, and where DT was used to reinforce the child's enthusiasm for physical activity.

CONCLUSIONS

Parents reported several valued practices where children were physically active, rather than sedentary, while using digital technology.

Social network characteristics and their relationships with physical activity in children with multiple sclerosis

BACKGROUND

Physical activity has been found to associate with improved health outcomes in children with multiple sclerosis (MS). Social networks may facilitate physical activity in children with MS.

OBJECTIVES

To estimate associations between social network characteristics and physical activity in children with MS compared to children with monophasic acquired demyelinating syndrome (mono-ADS).

METHODS

Children with MS and mono-ADS recruited from the Hospital for Sick Children completed questionnaires on social network and physical activity. Descriptive and inferential analyses estimated differences between cohorts and correlations.

RESULTS

Children with MS (n = 16) and mono-ADS (n = 22) did not differ in outcomes. Higher physical activity associated with larger social networks (rs= 0.681, p < 0.01), more Emotional Support (rs= 0.604, p < 0.05), Camaraderie (rs= 0.585, p < 0.05), more social network members with post-secondary education (rs= 0.680, p < 0.05), and members who exercise 3 to 4 times a week (rs= 0.744, p < 0.01). These associations were not found in children with mono-ADS.

CONCLUSION

Larger social network size, more emotional support and camaraderie, and more individuals with post-secondary education and who regularly exercise in the social network associated with higher physical activity in children with MS. Social network characteristics may help understand health behaviors in children with MS.

Prevalence and correlates of meeting 24-hour movement behavior guidelines among 8523 youth prescribed eyeglasses/contact lenses

BACKGROUND

Contemporary 24-h movement behavior (24-HMB) guidelines provide recommendations on time spent on physical activity (PA), screen time (ST), and sleep (SL). There is evidence of physiological and psychological health benefits associated with meeting such guidelines. However, the prevalence of meeting 24-HMB guidelines among youth prescribed eyeglasses/contact lenses is less clear. The primary purpose of this cross-sectional analysis was to examine the prevalence of partially or fully meeting 24-HMB guidelines in U.S. youth prescribed eyeglasses/contact lenses, and variations in meeting the guidelines by demographic, health status, and environmental attributes.

METHODS

Data from the 2021 National Survey of Children's Health (NSCH) yielded a target subpopulation of 8523 youth aged 6-17 years (54.22 % girls) prescribed eyeglasses/contact lenses. The representative sample of US children and adolescents was used to estimate the prevalence of meeting 24-HMB guidelines, and a multinomial logistic regression analysis was conducted to examine the odds of meeting 24-HMB guidelines by demographic, health status, and environmental variables.

RESULTS

Overall, only 6.57 % met all three 24-HMB guidelines, 23.74 % did not meet any of the three 24-HMB guidelines, and 3.57 %, 10.88 %, and 29.98 % met single guidelines for physical activity, screen time, or sleep duration, respectively, while 25.27 % met any of two 24-HMB guidelines. Female participants were less likely to meet PA + SL guidelines (OR = 0.57, 95 % CI [0.38, 0.56]) but more likely to meet ST + SL guidelines (OR = 1.52, 95 % CI [1.20, 1.91]). Hispanic participants were less likely to meet PA + ST (OR = 0.28, 95 % CI [0.14, 0.52]) guidelines and all three guidelines (OR = 0.41, 95 % CI [0.23, 0.71]) while participants identified as black (OR = 0.33, 95 % CI [0.21, 0.51]) were significantly less likely to meet ST + SL guidelines. With respect to health status, overweight status, repeated/chronic physical pain, and born premature, were detrimentally associated with meeting two or more 24-HMB guidelines. Living in neighborhoods with parks or playgrounds and neighborhood safety were positively linked to meeting the guidelines while living in neighborhoods with sidewalks or walking paths was negatively linked to meeting PA + ST guidelines.

CONCLUSION

In U.S. youth prescribed eyeglasses/contact lenses the prevalence of meeting all three 24-HMB guidelines was low, especially the low prevalence observed in female participants, Hispanic and black participants, participants with overweight status, repeated/chronic pain, born premature, living in neighborhoods with sidewalks. Policy makers should take initiative to promote integrated guidelines among this special age group for health benefits.

Exploring Individual Components of Sport Persistence in the Light of Gender, Education, and Level and Type of Sport

Background/Objectives: Sport persistence can be coded as an indicator of sport performance and commitment, incorporating personality traits such as resilience, adaptive coping, and positive personality traits. Thus, athletes do not merely persist in sporting activities but are qualitatively committed to them. Methods: In the present research, we used a qualitative methodology to investigate the factors underlying sport persistence, using Bronfenbrenner's socio-ecological model. In total, 133 high school and college student-athletes were surveyed in a semi-structured interview study. We set the following research question: How do the factors involved in developing sport persistence vary across athletes' gender, level of study, and level and type of sport? Data were analyzed along the lines of grounded theory. ATLAS.ti and IBM SPSS 22.0 statistical software were used for the analysis. Results: Our analysis divided individual motivation into intrinsic (health promotion, habituation, becoming a competitive athlete, self-improvement, self-actualization, relaxation, and sport enjoyment) and extrinsic motivation (family-related motivation, coach, social relationships, competition, livelihood, recognition). The cross-tabulation analysis revealed that contrary to the general trend, no significant differences can be experienced in the core motivational patterns contributing to sport persistence. However, significant differences could be detected concerning the level of education, level of sporting activity, and type of sport. Conclusions: Our findings not only shed light on the unique factors underlying sport persistence, but also challenge the trends observed in traditional sport motivation analyses. This insight could potentially revolutionize how we approach youth sport promotion and physical activity among young people, making our research highly relevant and impactful.

Does autonomous motivation and self-efficacy mediate associations between environmental factors and physical activity in adolescents?

BACKGROUND

To analyze the associations among autonomous motivation, self-efficacy, satisfaction of basic psychological needs, social support and perceived environment with physical activity practice of adolescents aged between 12 and 15 years; and to test autonomous motivations and self-efficacy as potential mediators of the associations between these environmental factors and physical activity practice.

METHODS

We evaluated 553 adolescents, that participated in the ActTeens Program. Physical activity was assessed using the Physical Activity Questionnaire for Adolescents. Autonomous motivation, self-efficacy, satisfaction of basic psychological needs, parents' social support and perceived environment were assessed using specifics questionnaires. Linear regression models were used to test the associations.

RESULTS

Parents' support (β = 0.32), satisfaction of basic psychological needs of colleagues (β = 0.21) and teachers (β = 0.12), and perceived environment (β = 0.10) had significant associations with physical activity (p < 0.05). The direct effect value was reduced when autonomous motivation was added as a mediator of the association between parents' support and physical activity (β = 0.24), with a 25% mediated effect. Autonomous motivation was mediator of the relationship between basic psychological needs of colleagues (β = 0.13; EM = 38%), teachers (β = 0.02; EM = 83%), and perceived environment (β = 0.03; EM = 70%) with physical activity.

CONCLUSION

Self-efficacy was not associated with physical activity and autonomous motivation was an important mediator of adolescents' physical activity.

Barriers and Facilitators for Physical Activity Among Children and Youth With Autism-A Scoping Review

BACKGROUND

The purpose of this scoping review was to systematically synthesize barriers and facilitators for physical activity (PA) among children and youth with autism spectrum disorders (ASD) across the socioecological model.

METHODS

Five electronic databases were searched in March 2022 for studies examining barriers and facilitators for PA among children and youth with ASD. An updated search was performed in April 2024. The framework synthesis method was utilized, and the socioecological model was the chosen framework.

RESULTS

Fifty-four studies published from 2008 to 2024 were included. Among the included studies, 57% included the perspectives of children and youth with ASD alone or together with proxies (eg, parents, teachers, and coaches), while 43% included only the perspectives of proxies. Barriers and facilitators on the intrapersonal and interpersonal levels were most substantial. The analysis led to 2 main categories of barriers and facilitators, those unique to children and youth with ASD, and those similar to what had been identified through research on children and youth, both typically developing and with other disabilities.

CONCLUSIONS

This comprehensive scoping review shows the complexity of factors contributing to barriers and facilitators for PA among children and youth with ASD, and highlights both the factors unique to this population and more general factors affecting PA participation. The findings from this synthesis might be used to guide the development of inclusive PA in physical education, organized sports, and other community PA arenas.

The pathway of social support in enhancing adolescents' physical fitness: The mediating roles of physical activity and self-efficacy

PURPOSE

Utilising Welk's Youth Physical Activity Promotion (YPAP) model as a foundational framework, this study investigates the intricate interplay of social support, physical activity (PA), and self-efficacy in relation to physical fitness within the context of Chinese culture. The primary objective is to identify the nuanced dynamics among social support, self-efficacy, PA, and physical fitness to enhance adolescent well-being and fitness.

METHODOLOGY

The study employed a convenience sampling method, engaging 123 adolescents aged 18-21, of which 67 were females (54.47%), and 56 were males (45.53%). Data were collected through structured questionnaires focusing on the identified variables.

RESULTS

Our study revealed significant positive associations among social support, self-efficacy, PA, and physical fitness, with correlation coefficients ranging from 0.282 to 0.419. Notably, a discernible gender disparity emerged, with females exhibiting higher levels of physical fitness. Among the key determinants of adolescent physical fitness, self-efficacy emerged as the most influential, followed by PA and gender. Utilising structural equation modelling and regression techniques, we discerned that social support indirectly influences physical fitness, primarily mediated by self-efficacy and the level of physical activity.

DISCUSSION

This study provides insight into how social support impacts adolescent physical fitness. We found that social support strongly predicts both PA and self-efficacy, and self-efficacy significantly boosts PA, ultimately leading to improved physical fitness. Both self-efficacy and PA serve as mediators in the relationship between social support and fitness. Therefore, interventions should prioritise reinforcing social support, promoting PA, and nurturing self-efficacy to optimise adolescent physical fitness outcomes.

Teacher perspectives on the socio-ecological barriers and enablers to food and nutrition education in primary schools: a scoping review

OBJECTIVE

Schools are identified as a setting for food and nutrition education (FNE) in childhood. FNE is a key strategy to optimise child growth and development and impart life-long food skills. There is limited synthesis of the literature to understand the socio-ecological determinants of teachers and schools engaging in FNE.

DESIGN

For this scoping review, five databases (APA PsycInfo, ERIC, Medline, CINAHL and Scopus) were searched using the terms (and synonyms for) primary school teacher, self-efficacy and food and nutrition. A quality assessment using relevant Johanna Briggs tools was carried out for the included papers. Data were extracted using a modified socio-ecological model, and narrative themes were identified.

SETTING

Primary (elementary) schools in high-income countries.

PARTICIPANTS

Primary-school teachers.

RESULTS

Forty-one papers were included in this review from ten countries (predominantly the USA). The narrative synthesis identified five themes that interact with teacher delivery of FNE. These were (i) perceived food and nutrition responsibilities of teachers, (ii) teacher beliefs and self-efficacy, (iii) opportunities to build teacher nutrition knowledge and self-efficacy, (iv) interpersonal contributors and (v) broader environmental, structural and policy contributors.

CONCLUSIONS

Multiple strategies are needed to build the capacity of teachers to undertake FNE within primary school settings. These strategies include a focus on learner-centred education that will build teacher agency, school leadership, ensuring the health and well-being of teachers and providing initial teacher education as well as innovative professional development for cross-curriculum integration. Strategies drawing from each level of the socio-ecological framework will increase opportunities for capacity building.

Physical activity and sedentary behavior among ambulatory children with cerebral palsy using accelerometer: a cross-sectional study

Background and objective

Physical activity (PA) is paramount for childhood development and growth. However, children diagnosed with Cerebral Palsy (CP) were often considered sedentary, and their physical inactivity was associated with adverse health conditions and complications. Therefore, this study aimed to objectively describe and compare the PA levels and SB levels of children with and without CP of the same age group. It also studied the factors correlating with PA, SB, and step count per day in children with CP.

Subjects and methods

A cross-sectional study using a wrist-worn accelerometer was conducted. PA and SB were measured over seven consecutive days.

Results

Eighty-five children aged 6-12 years, consisting of 41 children with CP and 44 TD children, participated in this study with a mean age of 9.18 ± 1.95 and 8.45 ± 1.78 years, respectively. According to the gross functional measures, 53.6% of children with CP were classified as first classification. A significant amount of time was spent in SB and Light PA (LPA) by children with CP compared to TD children, and no significant differences were observed in moderate PA (MPA) or step count. Gender mainly affected MPA as girls spent more time in MPA than boys. The age, height, and weight of children with CP correlate significantly with SB. As children's age, height, and weight increase, SB increases. Additionally, children with higher weights have lower step counts per day.

Conclusion

This study showed that children with CP spend more time in LPA and SB than typically developed children. Therefore, concerted efforts are needed to encourage physical activity and reduce the sedentary lifestyle, to take into account the gender and anthropometric measures of children to enhance the quality of life among children with CP, and to consider gender and anthropometric measures of the children.

Global Physical Activity, Active Commuting to School, and Sedentary Behavior Among Latin American Adolescents: Global School-Based Student Health Survey and the National School Health Survey

BACKGROUND

This study aimed to compare the overall prevalence, stratified by sex and age group of global physical activity (GPA), active commuting to school (ACS), and sedentary behavior (SB) among adolescents from ten Latin American countries, and to assess the correlation of Development Index with the indicators.

METHODS

This research is grounded on data from the Global School-Based Student Health Survey (2009-2015) and the 2015 Brazilian National School Health Survey. The prevalence and 95% confidence intervals for GPA (≥5 d/wk), ACS (≥1 d/wk), and SB (>2 h/d) were calculated using the chi-square test to compare the sexes (male; female) and age group (≤13 y; 14 y; 15 y; ≥16 y). We also performed Pearson correlation analysis with the Human Development Index.

RESULTS

The prevalence of indicators ranged from 16.1% to 28.2% for GPA, from 56.7% to 71.2% for ACS, and from 20.7% to 62.6% for SB. Boys generally had a higher prevalence of GPA and ACS, and girls had a higher prevalence of SB. The prevalence of the indicators by age group varied between countries, with significant differences observed in some, depending on each indicator. A positive correlation was observed between Human Development Index, GPA, and SB.

CONCLUSION

Health promotion policies must include guidelines that encourage and promote a more active and less sedentary lifestyle among young people in Latin America, considering specific groups, the local socioeconomic context, and differences between countries.

Sedentarism and Chronic Health Problems

Increased mechanization and technological advances have simplified our lives on the one hand and increased sedentary behaviors on the other hand, paving the way for emerging global health concerns, i.e., sedentarism, which could be the leading cause of all major chronic health problems worldwide. Sedentarism is a habitual behavior of choosing and indulging in low-energy expenditure activities (≤1.5 metabolic equivalents), such as chairtype (sitting, studying, traveling) or screen-type activities (TV, computers, mobile). With technological advancements, there is a significant transition in the lifestyles of people from being active (walking) to being more deskbound (sitting). Prolonged sitting can have unintended consequences for health with sitting time >7 h/d, leading to a 5% increase in all-cause mortality with each additional hour spent sitting (i.e., +7 h/d), while considering physical activity levels. This review will highlight how sedentarism is emerging as a major risk factor for the rising incidence of non-communicable diseases, especially among young adults and adults. Chronic diseases, such as obesity, diabetes, coronary heart disease, and cancer, are the leading causes of death worldwide. Hence, there is an urgent need for collective action to mitigate the burgeoning public health crisis posed by sedentarism in the 21st century. This paper intends to set in motion a call for all policymakers and public health professionals placed nationally or internationally to reach a consensus on ending sedentarism and provide viable resolutions for effective management of excessive sedentary behaviors and healthy adoption and maintenance of active lifestyles among individuals of all age groups.

"You are either sporty or you are not" a qualitative exploration of pre-teen girls of low-socioeconomic position experiences of being physically active

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Policies and opportunities for physical activity engagement in Austrian schools: a census survey

Background

Compelling evidence suggests that schools' infrastructure and policy represent potential predictors of health and physical activity (PA) in children and adolescents. However, the translation of these findings into practice has not been examined. This study investigated the activity friendliness of Austrian schools.

Methods

Using a census sampling method, principals of Austrian schools (n = 342) were invited to participate in an online survey assessing 1) the availability of PA facilities (e.g. playgrounds, sports courts, swimming halls) and 2) applied PA policies (e.g. cooperation with sports clubs and involvement in PA projects).

Results

A total of 130 principals answered the survey which corresponds to a minimal response rate of 38%. While most schools (87.4%, n = 111) had a gymnastic hall, only one third (37%, n = 47) had access to a swimming hall. On average, the schools had 4.2 ± 2 PA facilities with significant variation between school types (i.e., high schools: 5 ± 2 vs. primary schools: 3.5 ± 2, p < 0.05). The most common facilities were meadow areas (89%, n = 113), sports fields (71.7%, n = 91), and playgrounds (64.6%, n = 82). Almost half of the schools were part of a PA project (e.g. "active break", 45%, n = 56) and offered extracurricular PA programs and courses (54%, n = 67), but only one in five (22%, n = 27) regularly conducted fitness tests. PA policies varied between school types (p < 0.05) but almost all principals (94%, n = 117) would welcome a stronger promotion of activity friendliness at their school.

Conclusion

Schools are mostly activity-friendly regarding infrastructure although the limited possibilities for swimming lessons seem worrisome. PA promotion through projects, extracurricular PA offerings and fitness tests may be expanded.

A mobile app-based intervention improves anthropometry, body composition and fitness, regardless of previous active-inactive status: a randomized controlled trial

Introduction

The use of mobile apps to promote physical activity in adolescents can improve health-related parameters. However, previous studies have not evaluated whether the benefits depend on the users' prior active or inactive status. Therefore, the main objective was to analyze differences in physical activity levels, adherence to the Mediterranean diet (AMD), anthropometry, body composition, and physical fitness between active and inactive adolescents.

Methods

The study was conducted through a randomized controlled trial (RCT) with 462 adolescents, divided into experimental (EG) and control groups (CG), further categorized as active and inactive. Variables of physical activity, kinanthropometry, body composition, and physical fitness were measured before (pre-test) and after (post-test) a 10-week intervention using step-tracking apps (Strava, Pacer, MapMyWalk, and PokémonGo) at least three times per week.

Results

The results showed that inactive EG adolescents significantly increased their physical activity levels, body mass, and muscle mass, and improved in all fitness variables except the countermovement jump (CMJ). The sum of three skinfolds also significantly decreased. Active EG adolescents increased body and muscle mass and improved in all fitness variables. Additionally, they significantly reduced fat mass and the sum of three skinfolds. All covariates, mainly gender and maturity, had significant effects on the study variables. Comparing changes between the active EG and CG groups, significant differences were found in body mass index (BMI) and CMJ in favor of the EG. However, while significant differences were observed in the study variables when analyzing each app individually, there were no differences between the changes produced by each app in these variables.

Conclusion

After a 10-week program of physical activity promoted through step-tracking apps, improvements were observed in fat variables, cardiorespiratory fitness, and curl-up performance. Furthermore, only inactive adolescents perceived an increase in their level of physical activity. The measurement protocol was registered prior to the start of the intervention at ClinicalTrials.gov (code: NCT04860128).

"Losing access to outdoor spaces was the biggest challenge for children to be healthy": pandemic restrictions and community supports for children's movement in Nova Scotia

Introduction

Health-focused communities can promote physical activity for children by providing them with safe and supportive environments to move. Across the COVID-19 pandemic many community spaces and services were closed due to public health restrictions. During the pandemic, Atlantic Canada uniquely implemented an agreement between four provinces to restrict travel and reduce the spread of the virus. The "Atlantic bubble" led to fewer cases of COVID-19 and restrictions to community spaces and services. With restrictions now removed, community spaces and services likely play a critical role in facilitating the recalibration of children's movement. Perspectives from families who experienced the "Atlantic bubble" may offer valuable insights to the use of these spaces during and after the removal of restrictions.

Objective

This study explored the role of community spaces and services on their child's physical activity across the COVID-19 pandemic from the perspectives of Nova Scotia caregivers.

Methods

We employed a qualitative description approach and conducted semi-structured interviews with 14 caregivers of children aged 5-11 years who lived in Nova Scotia, Canada. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis.

Results

Four themes were generated: (1) Public health restrictions limited community movement behaviors and social connections, (2) Spaces, locations, and environments influenced how families experienced physical activity during public health restrictions, (3) Virtual realities: screens supported a new sense of community for children throughout the pandemic, and (4) "Facilitated" and "forced adaptability": public health restrictions changed family dynamics, routines, and movement behaviors.

Conclusion

Despite living in the "Atlantic bubble," Nova Scotian caregivers shared that COVID-19 related public health restrictions shifted their family's dynamics, routines, and ability to engage in physical activity within their communities. Community spaces and services can be leveraged to recalibrate children's movement as pandemic-related restrictions are reduced. In future public health crises, community spaces and services should remain in place to whatever extent possible to reduce the collateral consequences of public health restrictions on children's health.

Prevalence of childhood hypertension and associated factors in Zhejiang Province: a cross-sectional analysis based on random forest model and logistic regression

With childhood hypertension emerging as a global public health concern, understanding its associated factors is crucial. This study investigated the prevalence and associated factors of hypertension among Chinese children. This cross-sectional investigation was conducted in Pinghu, Zhejiang province, involving 2,373 children aged 8-14 years from 12 schools. Anthropometric measurements were taken by trained staff. Blood pressure (BP) was measured in three separate occasions, with an interval of at least two weeks. Childhood hypertension was defined as systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) ≥ age-, sex-, and height-specific 95th percentile, across all three visits. A self-administered questionnaire was utilized to collect demographic, socioeconomic, health behavioral, and parental information at the first visit of BP measurement. Random forest (RF) and multivariable logistic regression model were used collectively to identify associated factors. Additionally, population attributable fractions (PAFs) were calculated. The prevalence of childhood hypertension was 5.0% (95% confidence interval [CI]: 4.1-5.9%). Children with body mass index (BMI) ≥ 85th percentile were grouped into abnormal weight, and those with waist circumference (WC) > 90th percentile were sorted into central obesity. Normal weight with central obesity (NWCO, adjusted odds ratio [aOR] = 5.04, 95% CI: 1.96-12.98), abnormal weight with no central obesity (AWNCO, aOR = 4.60, 95% CI: 2.57-8.21), and abnormal weight with central obesity (AWCO, aOR = 9.94, 95% CI: 6.06-16.32) were associated with an increased risk of childhood hypertension. Childhood hypertension was attributable to AWCO mostly (PAF: 0.64, 95% CI: 0.50-0.75), followed by AWNCO (PAF: 0.34, 95% CI: 0.19-0.51), and NWCO (PAF: 0.13, 95% CI: 0.03-0.30). Our results indicated that obesity phenotype is associated with childhood hypertension, and the role of weight management could serve as potential target for intervention.

Physical Activity and Perceived Support among Adolescents According to Sex and Municipality

A cross-sectional study was conducted with three aims: (1) to determine the degree of compliance with physical activity recommendations among adolescents according to sex and place of residence, (2) to determine the perceived support of family and friends for physical activity among adolescents according to sex and place of residence, and (3) to analyse the influence of family and friends support on compliance with physical activity recommendations among adolescents according to sex and place of residence. A total of 694 adolescents from an inland area of Spain (14.06 ± 1.27 years) participated. Four one-day physical activity questionnaires were administered to assess physical activity and the Parental Support Scale and Peer Support to measure perceived support from family and friends regarding physical activity. Chi-square, Crammer's V and Student's tests were calculated to identify differences between variables according to sex and municipality of residence. Moreover, the initial binary logistic regression model was constructed to predict the physical activity compliance. Differences in adherence to physical activity recommendations were found according to the sex of the students (rural area: x2 = 4.192, p < 0.05; V = 0.106, p < 0.05; urban area: x2 = 8.999, p < 0.05; V = 0.167, p < 0.01). There were also sex differences in rural areas on items related to families providing transport (t = 3.878, p ≤ 0.001; d = 0.40) and doing physical activity together (t = 4.974, p ≤ 0.001; d = 0.50). It is concluded that most adolescents do not comply with physical activity recommendations. In addition, 30.4% of urban girls' compliance was predicted by the perception that their family members saw them doing physical activity and doing it with friends.

Stakeholder perspectives on the barriers and facilitators of engagement in healthy lifestyle behaviours in underrepresented adolescents: a focus group study from the European SEEDS project

BACKGROUND

Obesity in adolescence has increased in the last decades. Adolescents fail to meet the recommended guidelines for physical activity (PA) and healthy diet. Adolescents with a low socioeconomic status (SES) particularly seem to have fewer healthy lifestyle behaviours. The European Science Engagement to Empower aDolescentS (SEEDS) project used an extreme citizen science approach to develop and implement healthy lifestyle behaviour interventions in high schools. As part of this project, key stakeholders were invited to reflect on the intentions of adolescents to engage in healthy lifestyle behaviours. The aim of this study was to gain stakeholder insights into the barriers and facilitators to healthy lifestyle behaviours of adolescents from low SES areas and on the possible role of these stakeholders in facilitating healthy lifestyle behaviours.

METHODS

Six semi-structured focus groups were conducted in four European countries with 28 stakeholders from different settings (schools, community, and government), like teachers, policy advisors and youth workers. The theoretical framework of focus groups was based on the Theory of Planned Behaviour. The main questions of the focus groups were centred on PA and healthy diet. The focus groups were qualitatively analysed in NVivo using thematic analysis to identify topics and themes.

RESULTS

According to stakeholders, adolescents have sufficient understanding of the importance of PA and a healthy diet, but nevertheless engage in unhealthy behaviour. Parents were mentioned as important facilitators for engaging adolescents in healthy lifestyle behaviours. Stakeholders listed lack of knowledge, time, and financial resources as barriers for adolescents from low SES families to engage in healthy lifestyle behaviours. The school environment was listed as an important facilitator of adolescents' healthy lifestyle changes, but stakeholders acknowledged that current school days, curriculum and buildings are not designed to promote healthy lifestyle behaviours. External support and collaboration with community and governmental stakeholders was seen as potentially beneficial to improve healthy lifestyle behaviours.

CONCLUSIONS

This study shows the variety of barriers adolescents from low SES areas face, and the need for a broader collaboration between key stakeholders to facilitate healthy lifestyle behaviours. Schools are regarded specifically as important facilitators. Currently, the school environment entails various barriers. However, when addressing those, schools can increase opportunities for healthy lifestyle behaviours of adolescents from low SES areas.

TRIAL REGISTRATION

This study is registered in ClinicalTrials.gov on 12/08/2021: NCT05002049.

National trends and ecological factors of physical activity engagement among U.S youth before and during the COVID-19 pandemic: A cohort study from 2019 to 2021

BACKGROUND

This study aims to investigate the trends and ecological determinants of physical activity among U.S. children and adolescents during the 2019-2021 period, encompassing the COVID-19 pandemic's onset and subsequent years.

METHODS

Utilizing data from the National Survey of Children's Health over three years, this cohort study analyzed physical activity levels and ecological determinants among 82,068 participants aged 6-17. The sample included 36,133 children (44%) and 45,935 adolescents (56%), with variables assessed by caregiver reports.

RESULTS

The analysis revealed a significant decline in physical activity among children from 2019 to 2020, followed by a recovery in 2021, whereas adolescents showed a continued decrease without recovery. Over the study period, children were consistently more active than adolescents. Better health status, normal weight, less screen time, stronger peer relationships, higher parental involvement, better family resilience and greater school participation were consistently correlated with increased physical activity in both age groups. Sleep duration was a predictor of activity only in children, while mental health status was solely a predictor in adolescents. Neighborhood environment consistently predicted children's activity levels but was a significant factor for adolescents only in 2020.

CONCLUSIONS

These findings highlight the differing impacts of the pandemic on physical activity between children and adolescents, emphasizing the need for targeted public health interventions, particularly for adolescents whose activity levels have not recovered from the pandemic period. Age-specific physical activity interventions should consider sleep duration and neighborhood environmental factors when targeting children and mental health factors when focused on adolescents.

"A constant battle against sedentary lifestyle and screen time": Swedish school nurses' views on school children's physical activity and its promotion - a grounded theory study

School nurses are in a key position to promote children's physical activity. They engage all children in health dialogues and use different approaches to inform children about physical activity and motivate them to change their physical activity level. In a school context, it is important to explore and problematize school nurses' views of children's physical activity and the influence of these views on their professional practice in the school health service. Identifying and problematizing school nurses' views of physical activity would enable them to create improved guidelines and equivalent ways of working in the future. Therefore, this study aims to discursively explore Swedish school nurses' views on school children's physical activity and its promotion and elucidate them through a discursive framework based on sensitizing concepts. This study uses a qualitative research design with a constructivist grounded theory approach. Semi-structured interviews were conducted with 24 school nurses. The analysis resulted in a core category describing how school nurses use intertwined views to lead children from sedentarity to physical activity. Furthermore, the school nurses' practices were identified in three categories: fostering everyday movement as a tool for health, battling children's sedentarity under difficult conditions, and promoting everyday movement and compensating for unequal access. The results indicate that school nurses lack common and clear guidelines for their mission to promote physical activity to children, which may lead to inequality in access to physical activity for children and young people.

Refined Feasibility Testing of an 8-Week Sport and Physical Activity Intervention in a Rural Middle School

This study examines how the 8-week Hoosier Sport program impacts cardiovascular disease (CVD) risks by promoting physical activity (PA) among rural, low-income children. Using a human-centered participatory co-design approach, the program aimed to increase PA levels (e.g., total PA, daily steps) in at-risk children. The present study explored the feasibility of the intervention as well as physiological and psychological changes across the intervention using a hybrid type 2 design (a model that evaluates both the effectiveness of an intervention and its implementation in real-world settings). Favorable feasibility indicators like attendance, acceptability, and compliance, with a 23.3% recruitment rate and 94.3% retention rate, were observed. Moreover, participants attended over 80% of sessions across the 8 weeks. Accelerometers (AX3) tracked daily steps and total PA for 7 days before and after the intervention, revealing increased PA levels throughout. At post-intervention, notable improvements were observed in psychological factors such as autonomy, social competence, and global self-worth. This study highlights the importance of tailored PA interventions in schools, emphasizing their potential to improve PA levels among rural, low-income children.

Assessing the Acceptability of a Preschool-Based Multi-Component Physical Activity Intervention Entitled "I'm an Active Hero" (IAAH): Process Evaluation of a Feasibility Trial

BACKGROUND

Interventions within preschool settings have gained prominence due to the need to increase physical activity (PA) in early childhood. We first developed a 10-week preschool-based behaviour change intervention, guided by the UK Medical Research Council's framework for complex interventions. We then conducted a cluster feasibility randomised controlled trial (RCT) among young children.

AIM

This process evaluation was embedded within the cluster feasibility RCT and aimed to assess the acceptability of the 10-week IAAH intervention among both preschool staff and parents.

METHODS

The study utilised a mixed method, involving post-intervention questionnaires completed by preschool staff (n = 4) and children's parents/caregivers (n = 9) and focus groups with preschool staff (n = 3) and parents/caregivers (n = 7). Quantitative data were analysed using SPSS to calculate acceptability scores, while qualitative data underwent thematic analysis using NVivo 12.

RESULTS

The intervention was well-received, with preschool staff reporting a 94.5% acceptability rate (mean score of 10.4 out of 11) and parents/caregivers indicating an 86% acceptance rate (mean score of 5.2 out of 6). Thematic analysis of focus group discussions revealed facilitators to intervention delivery, such as user-friendly materials and alignment with preschool curricula, and identified barriers, including time constraints, spatial limitations, and policy conflicts. Parental engagement was hindered by time restrictions, although the intervention materials were praised for their clarity and visual appeal.

CONCLUSIONS

The findings suggest that the IAAH programme was acceptable to both preschool staff and parents. However, the identified barriers to intervention delivery and engagement should be addressed in the planning of a future cluster RCT to evaluate the efficacy of the intervention.

Determinants of Change in Physical Activity in Children during the Transition from Elementary to High School

INTRODUCTION

Effective public health interventions targeting factors that influence physical activity are urgently needed to reduce the age-related decline in physical activity in youth. The purpose of this study was to identify associations between physical activity and a set of potential influences on physical activity in children as they transition from elementary to high school.

METHODS

Participants were 951 children from South Carolina school districts who completed outcome and independent variable measures on at least two time points from the 5th to 11th grades in 2010-2017. The primary outcome variable was physical activity, measured by accelerometry. Independent variables included a comprehensive set of variables in the child, parent/home, school, and community domains. Children, parents and school administrators, and staff completed questionnaires to assess psychosocial and home, school, and neighborhood environmental influences. Growth curve analyses identified independent variables associated with physical activity over time, either as a main effect or as an interaction with age.

RESULTS

As main effects, self-efficacy, self-schema, sport participation, weekday outdoor hours, importance of child participating in sports and physical activity, safe to play outside, and Physical Activity Resource Assessment weighted score were positively associated with physical activity. The associations between physical activity and enjoyment motivation, appearance motivation, weekend outdoor time, and home equipment exhibited significant interactions with age. Enjoyment motivation influenced physical activity during the earlier years, whereas the remaining three variables influenced physical activity in the later years.

CONCLUSIONS

Interventions should target multiple domains of influences that may vary by age.

Adolescent mental health interventions: a narrative review of the positive effects of physical activity and implementation strategies

Introduction

The psychological well-being of adolescents is a global concern due to increasing societal pressures and mental health issues. Physical activity is known to enhance physical health and has potential benefits for mental health, including reducing symptoms of anxiety and depression, boosting self-esteem, and improving social skills. This narrative review explores how physical activity can serve as an intervention to help adolescents manage psychological stress and prevent mental health issues.

Methods

An extensive literature search was conducted using databases such as PubMed, PsycINFO, Web of Science, and Scopus. Keywords included "adolescent mental health," "physical activity," "psychological intervention," "types of exercise," "anxiety," "depression," "self-esteem," "social skills," and "emotional regulation." Studies were included based on relevance, peer-reviewed status, and involvement of adolescent populations. Data were extracted and analyzed qualitatively, focusing on the psychological impacts of different types of physical activity. Sixty one articles were eventually included.

Results and conclusion

The review identified multiple studies highlighting the positive effects of various physical activities on adolescent mental health. Aerobic exercises were found to improve mood and cognitive function, strength training reduced depressive symptoms and increased self-efficacy, team sports enhanced social skills and a sense of community, and mind-body practices like yoga and tai chi improved stress management and emotional regulation. The findings suggest that physical activity can play a significant role in promoting adolescent mental health. Implementation strategies in school and community settings, including integrating physical activity into school curricula, offering diverse activity options, training professional instructors, encouraging family and community involvement, and regular monitoring and evaluation, are recommended. Future research should address limitations such as sample diversity and long-term effects. This narrative review underscores the importance of physical activity in enhancing adolescent mental health. Effective implementation strategies and multi-sector collaboration are essential for maximizing the benefits of physical activity interventions.

Development and psychometric testing of a questionnaire for the Korea Youth risk behavior survey to assess physical activity behaviors

BACKGROUND

Physical activity is essential for physical, mental, and cognitive health. Providing evidence to develop better public health policies to encourage increased physical activity is crucial. Therefore, we developed an in-depth survey as part of the Korea Youth Risk Behavior Survey to assess the current status and determinants of physical activity among Korean adolescents.

METHODS

We developed an initial version of the questionnaire based on a review of validated questionnaires, recent trends and emerging issues related to adolescent physical activity, and the national public health agenda pertaining to health promotion. Content validity was confirmed by a panel of 10 experts. Face validity was confirmed through focus group interviews with 12 first-year middle school students. The test-retest reliability of the questionnaire was evaluated by administering it twice, approximately two weeks apart, to a sample of 360 middle and high school students. Additionally, the frequency or average number of responses was analyzed in a sample of 600 students who participated in the initial test-retest reliability evaluation of the questionnaire developed in this study.

RESULTS

Through item pool generation and content and face validity test, the final 15 questionnaire items were developed across five themes: levels of physical activity, school sports club activities, transportation-related physical activity, physical activity-promoting environments, and factors mediating physical activity. The test-retest reliability ranged from fair to substantial. Results from the newly developed survey reveal that only a minority of adolescents engage in sufficient physical activity, with only 17.2% and 21.5% participating in vigorous and moderate-intensity activities, respectively, for at least five days per week. Among school-based activities, 44.3% of students do not participate in school sports clubs due to reasons including absence of clubs and disinterest in exercise. The major motivators for physical activity are personal enjoyment and health benefits, whereas preferences for other leisure activities and academic pressures are the predominant barriers.

CONCLUSIONS

This study developed valid and reliable in-depth survey items to assess physical activity among Korean youths. It will hopefully enhance our understanding of adolescent physical activity, offering essential preliminary evidence to inform the development of public health strategies aimed at promoting adolescent health.

The Effectiveness of Physical Activity Policies in Center-Based Childcare: A Systematic Review and Meta-Analysis

Purpose: Many young children spend a significant portion of time in center-based childcare settings; however, these children are often not sufficiently active during care. Promoting physical activity through policy implementation is one mechanism which has the potential to increase physical activity. The purpose of this systematic review and meta-analysis was to provide an overview of physical activity policies implemented in childcare centers and determine their effect on children's physical activity. Methods: Electronic searches were conducted in CINAHL, Medline, PsycINFO, EMBASE, Scopus, SPORTDiscus, and Sports Medicine and Education Database. Two reviewers independently examined 3,286 articles to find peer-reviewed, original studies that assessed the impact of physical activity policies on children's physical activity. Random effects meta-analyses were used to determine the impact of policies. Results: A total of 13 articles met the inclusion criteria; in which 12 unique policies were implemented. Results of the meta-analyses suggest that introducing new physical activity policies did not increase children's moderate-to-vigorous physical activity (MVPA); however, compared to centers without a formalized physical activity policy, children in centers with a formalized policy engaged in significantly more MVPA and total physical activity. Conclusions: Introducing new physical activity policies alone may not be sufficient to increase children's engagement in physical activity, and it may be important to combine with capacity-building initiatives for childcare staff and early childhood educators. Results reinforce the value of childcare centers implementing their own formalized physical activity policies to support children's physical activity, which highlights the importance of regulating physical activity practices in childcare. Registration: CRD42022326037.

Association between yoga and related contextual factors with moderate-to-vigorous physical activity among children and youth aged 5 to 17 years across five Indian states

Physical inactivity is one of the four key preventable risk factors, along with unhealthy diet, tobacco use, and alcohol consumption, underlying most noncommunicable diseases. Promoting physical activity is particularly important among children and youth, whose active living behaviours often track into adulthood. Incorporating yoga, an ancient practice that originated in India, can be a culturally-appropriate strategy to promote physical activity in India. However, there is little evidence on whether yoga practice is associated with moderate-to-vigorous physical activity (MVPA) accumulation. Thus, this study aims to understand how yoga practice is associated with MVPA among children and youth in India. Data for this study were obtained during the coronavirus disease lockdown in 2021. Online surveys capturing MVPA, yoga practice, contextual factors, and sociodemographic characteristics, were completed by 5 to 17-year-old children and youth in partnership with 41 schools across 28 urban and rural locations in five states. Linear regression analyses were conducted to assess the association between yoga practice and MVPA. After controlling for age, gender, and location, yoga practice was significantly associated with MVPA among children and youth (β = 0.634, p < 0.000). These findings highlight the value of culturally-appropriate activities such as yoga, to promote physical activity among children and youth. Yoga practice might have a particularly positive impact on physical activity among children and youth across the world, owing to its growing global prevalence.

What are the important factors influencing the physical activity level of junior high school students: a cross-sectional survey

Background

Engaging in regular physical activity has been consistently linked to improved physical health and academic performance. Despite its known benefits, there is a concerning trend of decreased physical activity among children globally. The study primarily aims to investigate the level of physical activity among junior high school students in Taiyuan and analyse the main affecting factors from a socio-ecological perspective.

Methods

A cross-sectional study was conducted, involving 650 junior high school students from 7 schools in Taiyuan, and 648 valid questionnaires were ultimately collected. The data on students' physical activity levels were collected through the Children's Leisure Activities Study Survey Questionnaire, and the data on factors affecting students' physical activity were collected through the Student Perceived Factors Affecting Physical Activity Questionnaire.

Results

In this study, students from the 7th, 8th, and 9th grades participated in physical activities, averaging 214.500 min per week in moderate-intensity and 25.000 min in high-intensity activities, cumulatively averaging 280.000 min weekly. Notably, a significant disparity (p = 0.012) was observed in the combined duration of moderate and high-intensity activities, with male students engaging more time compared to their female counterparts (307.500 vs. 255.000 min). This variance extended across different grades, particularly evident in 8th graders who recorded the highest weekly high-intensity activity duration (31.000 min) and overall physical activity time (320.500 min), surpassing the 7th graders(p = 0.007 for high-intensity activities). Furthermore, an exploratory factor analysis of a 32-item questionnaire, designed to identify determinants of physical activity, revealed six principal components. These components were found to positively correlate with both moderate and high-intensity physical activities.

Conclusion

Results emphasize that educational institutions and community programs should collaborate to offer engaging weekend physical activity programs. Schools should develop and implement tailored physical education curricula addressing gender and grade differences. Furthermore, schools and local governments should invest in high-quality sports equipment and facilities.

Environmental Correlates of Physical Activity and Screen-Time in Youth with Autism Spectrum Disorder: A Seven-Country Observational Study

This cross-sectional observational study sought to examine the environmental correlates of physical activity and screen-time among youth with autism spectrum disorder (ASD). Parents of youth with ASD (n = 1,165) from seven countries/regions provided responses to an online survey form measuring environmental correlates (i.e., physical activity neighborhood environment, social network, social trust and cohesion, bedroom media, social home environment) and outcomes (i.e., physical activity, screen-time). Multiple linear regression analyses were conducted to determine environmental predictors of the outcomes. Physical activity neighborhood environment (B = 0.15, p = 0.047), social network (B = 0.16, p = 0.02), and social home environment (B = 1.07, p < 0.001) were significantly associated with physical activity, whereas social trust and cohesion and bedroom media were not. Further, social trust and cohesion (B = -0.14, p = 0.001), bedroom media (B = 0.10, p = 0.001), and social home environment (B = -0.16, p < 0.001) were significantly associated with screen-time while neighborhood environment and social network were not. The identified environmental attributes of physical activity and screen-time behaviors should be targeted for health promotion among youth with ASD.

Effects of physical exercise on adolescent short video addiction: A moderated mediation model

Objective

To discuss the effects of physical exercise (PE) on adolescent short video addiction (SVA) and analyze the mediating effects of self-control (SC) and the moderating effects of the cumulative ecological risk (CER), aiming to provide theoretical support for PE relative to adolescent SVA, investigate the underlying mechanisms of the effects of PE.

Methods

The Physical Activity Rating Scale-3, Problematic TikTok Use Scale, Self-Control Scale, and Cumulative Ecological Risk Scale were used to survey 756 adolescents in Chongqing and Chengdu, China. SPSS was used to construct a research model by conducting reliability, confirmatory factor, common method bias, and AMOS analyses.

Results

PE was significantly and negatively related to adolescent SVA (β = -0.30, p < 0.01). SC served as a partial mediator between PE and adolescent SVA, the direct and indirect effect values are -0.304 and -0.167 respectively, showing that SC negatively predicted the relationship between the two variables. The CER moderated the effect of PE (t = -11.679, p < 0.001) and SC (t = -15.069, p < 0.001) on adolescent SVA.

Conclusion

PE mitigates and moderates adolescent SVA through the mediating effect of SC and the moderating effect of CER.

Child, family and household characteristics associated with physical activity in Samoan children aged 3-8 years: A cross-sectional study

Physical activity is a key component of many obesity prevention strategies. The aim of this analysis was to identify child, family, and household characteristics associated with parent-reported physical activity in Samoan children aged 3-8 years. Children (n = 445; 51.2% female, mean age 5.4 years) were part of an ongoing, mixed-longitudinal study of child growth, development, and wellbeing (the Ola Tuputupua'e cohort). Bivariate analyses and multivariate generalized linear regressions were conducted to investigate the relationship of child, family, and household characteristics with physical activity level, measured using the Netherlands Physical Activity Questionnaire (NPAQ). Children were classified as being 'highly active' if they had NPAQ scores in the 75th percentile or above. Among the n = 111 children classified as 'highly active', n = 67 (60.4%) were boys. After adjusting for child, family, and household-level characteristics, hours of child sleep per night was the only variable significantly associated with odds of being highly active. Compared to children who slept less than 9 hours at night, those who slept 10-10.99 hours (OR: 5.97, 95% CI: 2.14-18.13) and 11+ hours (OR: 25.75, 95% CI: 8.14-90.12) had higher odds of being 'highly active'. Future research should examine the mechanisms driving the relationship between nighttime sleep and physical activity among Samoan children. Intervening on sleep duration and quality may improve physical activity and, in turn, obesity risk in this setting.

Change in general and domain-specific physical activity during the transition from primary to secondary education: a systematic review

BACKGROUND

Knowledge of changes in the domains of physical activity (PA) during the transition period from primary to secondary education and the factors associated with these changes, are prerequisites for the design of effective PA promotion strategies. Therefore, the first aim of this study was to systematically review changes in general, leisure-time, school, transport, work, and home PA across the transition from primary to secondary education. The second aim was to systematically review the individual, social, and physical environmental factors that were associated with these changes.

METHODS

Records published up until September 2023 were retrieved from five electronic databases. We included longitudinal and cross-sectional studies that investigated general or domain-specific PA from 2 years before to 2 years after the transition from primary to secondary education. Information on source, study characteristics, sample characteristics, PA, and factors were extracted from the papers included. We reported the direction of change in general and domain-specific PA and the direction of association of the factors with change in general and domain-specific PA.

RESULTS

Forty-eight papers were included in the study. The evidence on changes in PA and associated factors was greatest for general PA. A limited number of the studies investigated the separate domains of leisure-time, school, and transport. Most studies on general and school PA reported a decline in PA, but there were no consistent results for the domains of leisure-time and transport. With respect to the associated factors, evidence was predominantly found for individual factors and to a lesser degree for physical environmental and social environmental factors. None of the factors were consistently associated with changes in general or domain-specific PA during the school transition.

CONCLUSIONS

For the design of targeted PA promotion strategies, further studies are warranted to explore changes in the specific domains of PA across the transition from primary to secondary education, especially in the domains of leisure-time, transport, home, and work PA. In addition, the interactions between factors at different socioecological levels to influence changes in PA need to be addressed more in the future.

TRIAL REGISTRATION

PROSPERO CRD42020190204.