Individual, Interpersonal, and Organizational Factors Affecting Physical Activity of School Adolescents in Pakistan

Effectiveness of a school-based physical activity intervention on overweight and obesity among children and adolescents in Pakistan

BACKGROUND

Childhood obesity poses a significant public health challenge, yet effective school-based physical activity (PA) interventions remain scarce, especially in Pakistan. There is a lack of data assessing the impact of such interventions on obesity and related health outcomes in Pakistani school children.

METHODS

This study aimed to design and implement a school-based intervention targeting multiple levels of the socio-ecological model to increase physical activity and reduce the prevalence of overweight and obesity in Pakistani youth. Conducted from October 2022 to January 2023 in Lahore, Pakistan, the 12-week, non-randomized controlled trial involved 1,200 students from eight schools, with four schools (n = 570) in the intervention group and four (n = 630) in the control group. Primary outcomes included changes in body mass index (BMI), waist circumference, and the prevalence of overweight/obesity, measured through anthropometric assessments. Secondary outcomes involved alterations in moderate-to-vigorous physical activity duration. Descriptive statistics, Chi-square tests, general linear mixed models, and repeated measures ANOVA were used for analysis.

RESULTS

The intervention showed significant improvements across various socio-ecological levels. Intrapersonal factors saw a reduction in fast food consumption from 11.9% to 7.9% (F(1,1198) = 90.39, p < 0.001; η² = 0.074) and an increase in physical activity frequency from 11.9% to 39.6% (F(1,1198) = 465.25, p < 0.001; η² = 0.028). Screen time decreased from 27.0% to 7.4% (F(1,1198) = 219.83, p = 0.015; η² = 0.15), and normal sleep duration increased from 44.6% to 71.8% (F(1,1198) = 242.73, p < 0.001; η² = 0.16). At the interpersonal level, parental involvement in encouraging sports and providing financial support for sports activities significantly increased. School-level factors also showed positive changes, including improved sports facilities and equipment access. Community-level factors revealed increased opportunities for physical activity and a more supportive community environment. The intervention group's BMI change (-0.06 ± 0.07 kg·m²) significantly differed from the control group's (0.19 ± 0.09 kg·m²).

CONCLUSIONS

This study demonstrates the effectiveness of a multi-level intervention in boosting physical activity and addressing obesity among Pakistani school-aged children, supporting the implementation of similar school-based interventions.

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.

Associations of School-Level Factors and School Sport Facility Parameters with Overweight and Obesity among Children and Adolescents in Pakistan: An Empirical Cross-Sectional Study

Childhood overweight and obesity are increasingly prevalent in Pakistan, posing significant public health challenges. This study explores the associations of school-level factors and school sports facility parameters with overweight and obesity among children and adolescents in Pakistan. A cross-sectional study across seven random districts in Punjab province, Pakistan, was conducted using a representative multistage random cluster sample. Underweight (BMI < 5th percentile), overweight (85th ≤ BMI < 95th percentile), and obese (95th percentile ≤ BMI) were defined using the US Center for Disease Control (CDC) 2000 criteria. Statistical analyses including the Chi-square test, Pearson correlation coefficient, and linear regression were performed to investigate predictive characteristics. Logistic regression analysis assessed the simultaneous impact of several covariates on dichotomous outcomes, with 95% confidence intervals (CIs) computed and a significance level set at p < 0.05. The study included 4108 Pakistani school children aged 9 to 17 years (mean age = 13.92 years, 59.3% boys) from 62 schools. The prevalence of overweight and obesity was 19.4% and 10.7%, respectively. Findings revealed a concerning lack of physical education activities (60% reported 0 sessions per week), morning exercise (60%), and classroom exercises (66%) among school-aged children. Leadership attitudes toward physical education (β = 0.04, p = 0.006) and students' satisfaction with the playground (β = 0.05, p = 0.015) showed significant associations with body weight status. Conversely, provision of physical education facilities, effective fund utilization for physical education, meeting school sports facility requirements, and weekend opening of school sports grounds did not significantly impact weight status. Satisfaction with the playground was significantly associated with a lower risk of overweight (OR 0.81, 95% CI 0.69-0.95, p < 0.05), indicating reduced overweight likelihood among students satisfied with school playgrounds. The study underscores significant gaps in promoting physical activity within school environments and highlights the urgent need for interventions to enhance physical education resources and sports facilities, aiming to create healthier school environments and reduce overweight and obesity prevalence among students. Further research and interventions are crucial for promoting lifelong physical activity habits and improving student health and well-being.

Psychosocial and Environmental Correlates of Physical Activity in Korean Adults

Using hypothesized structural equation modeling, we investigated contributions to physical activity (PA) from psychological, social, and environmental variables. Participants were 768 adults aged 30 years or older (men = 353, women = 415; Mage = 42.51, SD = 10.21 years) living in Jungrang-gu, Seoul. To assess psychological, social, and environmental variables, respondents completed scales measuring self-efficacy, decisional balance, social support, physical environment, and leisure time exercise. We found that psychological, social, and environmental variables had a statistically significant effect on PA, with psychological variables mediating the effects of social and physical environmental variables on PA. These findings lend support to the assumed internal and external validity of the social ecological model (SEM) as an explanation for PA.

A meta-analysis of the relationship between social support and physical activity in adolescents: the mediating role of self-efficacy

Introduction

Social support influences physical activity (PA) in adolescents. However, whether mediating and moderating effects impact the relationship between them or the underlying mechanism remains unclear. This study aimed to investigate the mediating effects of self-efficacy as well as a series of moderating influences using a meta-analytic approach.

Methods

A total of 56 studies published between January 2001 and May 2023 were obtained from the Web of Science, EBSCO, Taylor and Francis, Scopus, Wiley, ProQuest, and CNKI (core) databases, comprising 65 independent samples (total sample size = 47,196).

Results and discussion

The mean weighted correlation coefficients between social, family, peer, and school support and adolescent PA were 0.298, 0.226, 0.256, and 0.142, respectively, which were significant, except for school support. Family support and teenage PA were related, although the connection was moderated by gender and socioeconomic characteristics. While social, family, and peer support had a direct influence on adolescent PA, school support did not. Self-efficacy mediated the relationship between social support and its subtypes and adolescent PA.

Motivation toward Physical Activity and Healthy Habits of Adolescents: A Systematic Review

Adolescence is a transformative period in which rapid physical, cognitive and psychosocial growth takes place. Laying the foundation for healthy behaviors is paramount during these formative years. The aim of this review is to determine which countries are leading in research on adolescents’ motivation towards physical activity and healthy habits and their main findings. A systematic review was conducted following the PRISMA statement using the Web of Science and Scopus databases during the months of September to December 2022. The search terms used were: “Physical activity”, “Motivation” and “Adolescents”, in the following research areas: Education, Educational Research and Sport Sciences. A total of 5594 articles were identified, but only those that met the established criteria were included (32 articles). It is concluded that most of the research is led in Spain with 16 articles, followed by 3 in Chile, 2 in Portugal, 2 in Norway and the rest of the countries with 1. Likewise, most of the works include very similar aspects regarding the incidence of motivation towards the adherence to the practice of Physical Activity and healthy habits.

A Meta-Analysis of Social Ecological Correlates of Physical Activity Among Koreans

From the viewpoint of behavioral medicine, analyzing various factors that determine physical activity (PA) is necessary to promote PA participation. In this study we aimed to identify the impact of constructs within the social ecological model (SEM) on PA within the Korean population. We reviewed journal articles and dissertations published between February 2012 and May 2022 in this meta-analysis. We searched the Korean Education Research Information Service (KERIS), Korean Information Service System (KISS), National Digital Library (NDL), PubMed Central (PMC), SCOPUS, and Web of Sciences; and we located 13 studies to include in this review. Collectively, these studies indicated that most SEM constructs were significantly correlated with PA. Self-efficacy was most strongly correlated (0.67), followed by perceived benefits (0.48), quality of exercise facilities (0.37), accessibility of exercise facilities (0.33), friend support (0.29), and family support (0.23). These data provide practical information for basing a PA promotion strategy on SEM to enhance community health through behavioral psychology.

Analysis of Factors Related to Adolescents’ Physical Activity Behavior Based on Multichannel LSTM Model

The health problems of teenagers are closely related to their sports behavior. In order to understand the relevant factors of teenagers’ sports behavior, we use a variety of research methods to make a brief theoretical analysis of the relevant factors of teenagers’ sports behavior and analyze the impact of the model on teenagers’ sports behavior from different levels. The model analyzes the factors affecting youth sports behavior, reveals the relationship between these factors, puts forward corresponding intervention strategies, and uses effective means to develop youth sports practice. Therefore, based on the analysis of the relevant factors of teenagers’ sports behavior, this paper puts forward the LSTM model from many aspects, which shows that our model can be very effective in analyzing the factors affecting teenagers’ sports behavior.

Barriers and Facilitators of Physical Activity

Background Physical inactivity accounts for 16.6% of deaths in the United Kingdom. This study aims to review the recent (2016–2021) systematic reviews (SRs) on the facilitators and barriers to physical activity (PA) participation among (UK)-based adults.

Methods Using the Participants, Interventions, Comparators, and Outcomes framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy, a SR of SRs of studies on the facilitators and barriers to PA among (UK)-based adults, published between 2016 and December 3, 2021, in the PubMed, SCOPUS, or Cochrane Database of Systematic Reviews, was done.

Results Three SRs (each published in 2016, 2019, and 2021) were included and reviewed in the study. None of the reviewed SR included a study conducted during the coronavirus disease 2019 (COVID-19) pandemic; also, a paucity of primary studies on PA among (UK)-based adult black, Asian, and ethnic minorities populations was recorded. Having a knowledge/appreciation of the benefits of PA, having the opportunity for social interaction/participation and PA-related support, and having a safe environment for PA were the persistently reported facilitators to PA among (UK)-based adults. On the other hand, having language difficulties/language barrier, lack of time, and having underlying health problems were the persistently reported barriers to PA among them. Not all the included SRs received project funding.

Conclusion The outcomes of this study had identified contemporary research gaps regarding the current challenges related to PA among (UK)-based adults. It is a fact that COVID-19 has come to stay in the (UK) and, as a result, it has affected ways of living, especially PA; hence, there is an imminent need for a SR to collate current primary evidence, with regards to the COVID-19 pandemic, on the facilitators and barriers of PA among (UK)-based adults.

A School-Based Multilevel Intervention to Increase Physical Activity of Adolescents in Pakistan: From a Social-Ecological Perspective

This study aimed to develop an intervention strategy based on the social-ecological model’s individual, interpersonal, and organizational levels for increasing adolescents’ physical activity in Pakistan. Based on the social-ecological model, an 8-week intervention was conducted for 618 school students in Rawalpindi, Pakistan. A quantitative method with a quasi-experimental design was adopted, administering self-report measures before and after the intervention. Intervention materials were delivered by leaflet once a week to the intervention group. Repeated measure analysis of variance was applied to verify the intervention effects at pre- and post-test conditions. The results show that a significant intervention effect was identified from the repeated measure analysis of variance for the intervention group’s physical activity participation compared to the control group from baseline (M = 12.01, SD = 0.136) to the 8-week post-test (M = 16.30, SD = 0.125). The intervention based on the social-ecological model has sufficiently and effectively improved physical activity among school adolescents in Pakistan.