Physical Activity and Sports Participation in Irish Adolescents and Associations with Anxiety, Depression and Mental Wellbeing. Findings from the Physical Activity and Wellbeing (Paws) Study

"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.

Patterns of Physical Activity of Adolescents With ADHD in the School Context: A Cross-Sectional Study for Clinical Practice

OBJECTIVES

To describe the daily Physical Activity (PA) patterns of adolescents with Attention-deficit/hyperactivity disorder (ADHD), to analyze the differences in terms of PA patterns between adolescents with ADHD and those without ADHD, and to study the factors associated with achieving the daily PA recommendations.

METHODS

The sample was composed of 778 adolescents who provided complete information on their PA patterns through the Physical Activity Questionnaire for Adolescents (PAQ-A). Of these, 97 had ADHD according to DSM-5 criteria.

RESULTS

The results show that being a girl or being of foreign origin and having ADHD have an impact on the achievement of the recommended amount of daily PA.

CONCLUSIONS

When promoting PA in adolescents with ADHD within the school environment, it is necessary to consider different domains and specific contexts of a school day, paying special attention to girls and adolescents with ADHD of immigrant origin.

"It's what mothers do." A qualitative exploration of mothers' experiences of supporting their daughter to be physically active

OBJECTIVE

Girls are more at risk than boys of the non-communicable diseases associated with insufficient levels of physical activity (PA), therefore it is important to explore the reasons why girls maintain or cease to be physically active. Maternal support plays an important role in girl's PA, yet the factors influencing mothers' support of their PA have received limited exploration. In response, the aim of this study was to explore, mothers' experiences of supporting their daughters to be physically active and their perceptions of the factors that might influence these experiences.

METHOD

Semi-structured interviews were conducted with a purposive sample of mothers (n = 29) of girls (Mean age = 10.9 years; SD = 0.6). Reflexive Thematic Analysis was used to analyse the data, with themes mapped to the relevant domains of the Theoretical Domains Framework.

RESULTS

Themes highlighted how mothers described providing PA support as an inherent part of their parental role and how their role was influenced by their own PA identity. Mothers recognised that the type and amount of support they provided was impacted by the community setting in which they lived. Mothers acknowledged how the role of others (e.g., partners, grandparents, peers) added a layer of complexity to supporting their daughters to be active.

CONCLUSION

This study advances our understanding of maternal PA support behaviours recognising the complex interplay of individual, social and environmental factors. Additionally, the use of the Theoretical Domains Framework presents an in-depth behavioural diagnosis which can be used to inform future theory-based interventions to promote parent support of children's PA.

Moving well-being well: Using machine learning to explore the relationship between physical literacy and well-being in children

Physical literacy provides a foundation for lifelong engagement in physical activity, resulting in positive health outcomes. Direct pathways between physical literacy and health have not yet been investigated thoroughly. Associations between physical literacy and well-being in children (n = 1073, mean age 10.86 ± 1.20 years) were analysed using machine learning. Motor competence (TGMD-3 and BOT-2) and health-related fitness (PACER and plank) were assessed in the physical competence domain. Motivation (adapted-Behavioural Regulation in Exercise Questionnaire) and confidence (modified-Physical Activity Self-Efficacy Scale) were assessed in the affective domain. Well-being was measured using the KIDSCREEN-27. Accuracy of predicting well-being from physical literacy was investigated using five machine learning classifiers (decision tree, random forest, XGBoost, AdaBoost, k-nearest neighbour) in the full sample and across subgroups (sex, socioeconomic status [SES], age). XGBoost predicted well-being from physical literacy with an accuracy of 87% in the full sample. Predictive accuracy was lowest in low SES participants. Contribution of physical literacy features differed substantially across subgroups. Physical literacy predicts well-being in children but the relative contribution of physical literacy features to well-being differs substantially between subgroups.

Self-Esteem, Meaningful Experiences and the Rocky Road-Contexts of Physical Activity That Impact Mental Health in Adolescents

Abundant evidence shows that physical activity benefits adolescents' mental health and wellbeing. Quantitative evidence has shown that adolescents engaging in leisure time physical activity, a number of sports, and team sport, display better mental health outcomes than their peers. The specific contextual factors that contribute to increased mental health and wellbeing through physical activity are, as yet, unconfirmed. The purpose of this study was to identify the contexts of physical activity and sport that positively impact mental health and wellbeing as perceived by adolescents. A sample of 58 adolescents participated in 13 focus groups discussing various factors related to physical activity, sport and mental health. Participants brought an object that represented physical activity and an image that represented wellbeing to each focus group to aid in the discussion and representation of both. An inductive thematic analysis was conducted on transcripts of the focus groups using a six-phase approach. Five key themes were identified: (1) achievements and improvements leading to increased self-esteem; (2) the importance of meaningful experiences, a sense of belonging and contributions to identity; (3) development of resilience and responding to setbacks; (4) social connectedness and relatedness, and (5) an opportunity to experience mindfulness, distraction and flow-states. In order to enhance and support wellbeing through physical activity, adolescents should be encouraged and provided with opportunities to engage in enjoyable activities with people with whom they experience a sense of belonging, where there is an opportunity to experience mastery and improvement and that includes an element of autonomy or choice.

Feasibility of a peer-led, after-school physical activity intervention for disadvantaged adolescent females during the COVID-19 pandemic: results from the Girls Active Project (GAP)

Introduction

There is a critical need for interventions that can be feasibly implemented and are effective in successfully engaging adolescent females in physical activity (PA). A theory-based, peer-led, after-school PA intervention, the Girls Active Project (GAP), was codesigned with adolescent females. This study aimed to assess the feasibility of implementing and evaluating the GAP programme.

Setting

One single-sex, female-only, designated disadvantaged postprimary school (students aged 12–18) in Dublin, Ireland.

Methods

Mixed methods were applied with multiple stakeholders over a 12-week trial (March to May 2021). A single-arm study design was used to examine intervention: reach, dose, fidelity, acceptability, compatibility and context. Feasibility of using proposed self-reported outcome measures (moderate-to-vigorous PA levels, self-rated health, life satisfaction, PA self-efficacy and PA enjoyment) was also explored. Due to school closure resulting from the COVID-19 pandemic, the intervention was delivered both online and in person in the school setting.

Results

Eight exercise classes were peer delivered by project leaders (n = 6, students aged 15–17) to intervention recipients (students aged 13-14). Recruitment was low (n = 8, 10% of eligible students, mean age: 13.3 SD: 0.46), yet retention was high (n = 7/8, 88%). Attendance rates were satisfactory (68%), and the intervention was implemented with high fidelity (87%). Data completion rates suggested proposed self-reported outcome measures were deemed appropriate (≥ 95%), except for weight (50%) and height data (80%). Despite COVID-19 hindering intervention implementation, both quantitative and qualitative data suggested that stakeholders were satisfied and perceived the in-person delivered intervention to be compatible with the school setting. Recommended refinements included extending class duration, introducing different rewards, and boosting programme awareness.

Conclusions

Further thought must be given on how to increase recruitment. Overall, the in-person delivered after-school PA programme was well-received by stakeholders and shows promise as an intervention that can be feasibly implemented and evaluated. Suggested improvements to the GAP intervention programme are recommended, before continuing to a more robust evaluation.

Trial registration

10.17605/OSF.IO/75HWJ (prospectively registered, date of registration: 9th December 2020)

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01149-2.

Physical exercise, depression, and anxiety in 2190 affective disorder subjects

BACKGROUND

This study evaluated associations of PE with symptomatic status in mood and anxiety disorder subjects, and considered many other associated factors so as to expand on comparable previous studies.

METHODS

Consenting adults at a mood disorder center were assessed for associations of PE frequency ([never, past only, ≤once/week] vs. regularly at 2-3- or >3-times/week) with standard psychometric measures of depression and anxiety symptoms, selected demographic, clinical factors, using bivariate and multivariate methods.

RESULTS

Of 2190 subjects (58.8% women; mean age 42.6 years; 44.8% with major depressive, 40.6% bipolar, and 14.6% anxiety disorders), 22.5% currently engaged in regular PE. Such engagement was associated with lower morbidity ratings, youth, male sex, being unmarried, more education, higher socio-economic status (SES), less religious practice, less early abuse, younger age at illness onset and at intake, fewer years ill, lower BMI, fewer siblings, hyperthymic temperament, less time depressed before intake, and living at higher population density. Greater PE-frequency was associated with lower ratings of depression (but not anxiety), male sex, younger age, and lower BMI. Factors independently associated with PE in multivariate modeling ranked by significance: older age at intake ≥ lower BMI > more education > higher SES > male sex.

LIMITATIONS

PE assessment did not include type, intensity or duration. Some information provided may be subject to recall bias, though it should not affect comparisons among subjects.

CONCLUSION

Regularly repeated PE again appeared to be beneficial for patients with depression or anxiety and should be included in their treatment interventions.

Co-design of a school-based physical activity intervention for adolescent females in a disadvantaged community: insights from the Girls Active Project (GAP)

BACKGROUND

Globally, adolescents' physical activity (PA) participation rates are low, particularly among lower socioeconomic groups, with females consistently the least active. The aim of this study was to co-design, with adolescent females, a school-based PA intervention in a single-sex, females-only designated disadvantaged post-primary school in Ireland. This involved using the Behaviour Change Wheel (BCW) and Public and Patient Involvement (PPI). This paper outlines the novel methodological approach taken.

METHODS

The three stages 1) understand the behaviour, 2) identify intervention options, and 3) identify content and implementation options of the BCW guide is described. A student PPI Youth Advisory Group (YAG) (n = 8, aged 15-17) was established. Mixed-methods were used with students (n = 287, aged 12-18) and teachers (n = 7) to capture current self-reported PA levels and to identify factors influencing adolescent females' PA behaviour in their school setting. The intervention options, content and implementation options were identified through discussion groups with the YAG. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention.

RESULTS

Just 1.4% of the students in this sample reported meeting the recommended PA guidelines. Students identified having more 'time' as the strongest predictor to becoming more active in school (Mean = 4.01, 95% CI 3.91 to 4.12). Social influences, environmental context and resources, behavioural regulation, beliefs about capabilities, goals, and reinforcement emerged from the qualitative data as factors influencing PA behaviour at school. The BCW co-design process resulted in the identification of seven intervention functions, four policy categories and 21 Behaviour Change Techniques. The Girls Active Project (GAP) intervention, a peer-led, after-school PA programme was proposed.

CONCLUSIONS

This paper describes how the BCW, a comprehensive, evidence-based, theory-driven framework was used in combination with PPI to co-design a school-based intervention aimed to increase adolescent females' PA levels. This approach could be replicated in other settings to develop targeted behavioural interventions in populations with specific demographic characteristics.

The Effect of Problematic Social Media Use on Happiness among Adolescents: The Mediating Role of Lifestyle Habits

Background: Although the relationship between problematic social media use (PSMU) and happiness has been already explored, less is known about the mechanisms that translate PSMU into lower happiness through lifestyle habits. Therefore, the current study focuses on the association between PSMU and happiness, exploring a mediating effect of lifestyle habits (e.g., difficulties in getting to sleep and frequency of physical activity) among Italian adolescents. Methods: A total of 58,976 Italian adolescents (mean age = 13.6, SD = 1.63; age range = 10.5−16.5; 49.4% females) were included. The pattern of relationships specified by the theoretical model was examined through path analysis. Results: Difficulties in getting to sleep (β = −0.037, p < 0.001) and frequency of physical activity (β = −0.012, p < 0.001) were mediators in the relationship between PSMU and happiness. Multi-group analyses across gender and age groups (11, 13, and 15 years old) showed that the chain mediating effect of the frequency of physical activity on the difficulties in getting to sleep was not significant for females but significant for males and for all of the three age groups. Overall, females and older ages were sensitive to the whole model. Conclusion: Along with difficulties in getting to sleep and the frequency of physical activity, lifestyle habits may contribute to the association between PSMU and happiness. We also recommend that future studies focus on PSMU in females and older adolescents, as they show more general sleep problems and reduced physical activity.

Effects of an 8-Week Intervention Targeting the Veridicality of Actual and Perceived Motor Competence Among Irish Adolescents in Project FLAME

High levels of perceived motor competence and low levels of actual motor competence in youth populations have been reported world-wide. Both perceived and actual motor competence have been deemed independent correlates of health and physical activity (PA) behavior, and past research has indicated that their alignment may be linked to more consistent PA. Moreover, there is potential for a movement-based intervention to strengthen the alignment between perceived and actual motor competence, perhaps then guiding future health, PA, and community sport engagement globally. Thus, the objective of this study was to investigate the effectiveness of an 8-week movement-based intervention on increasing the alignment (i.e., veridicality) between PMC and AMC among Irish adolescent youth. We collected data on adolescents (n = 324; females = 149; M age = 14.5, SD = 0.88 years) across six second-level schools in Ireland, including measurements of actual and perceived, motor competence at pre- and post-intervention. We observed low levels of actual in contrast to high levels of perceived motor competence. We found a small but significant veridical alignment between perceived and actual motor competence, but there was no intervention effect on alignment. Future research should prioritize a longer intervention duration that targets student learning and understanding in order to develop veridical perceptions in adolescents that might sustain their participation in PA.

Seasonal changes in the physical activity levels of youth Gaelic football players

This study quantified changes in physical activity (PA) levels attained by adolescents during Gaelic football (GF) participation across two time points in a season and determined if these changes affected their overall daily PA levels. A total of 130 adolescents (65 females;15.3 ± 1.5 years) wore an activPAL accelerometer to determine total moderate PA (MPA), vigorous PA (VPA) and moderate-to-vigorous PA (MVPA) during a seven-day measurement period, including during GF. The PA measurement was completed at "preseason" (T1) and "in-season" (T2) timepoints. Between T1 and T2, females significantly increased time spent in MVPA daily (p < 0.001, d = 0.95), on Gaelic football days (GFDs) (p = 0.036; d = 0.30), on non-Gaelic football days (NGFDs) (p < 0.001; d = 0.43), and during GF (p < 0.001, d = 0.90). Males did not record any significant changes in PA over time (p > 0.05). At T2, there were no significant differences in time spent in MVPA daily, on GFDs and NGFDs, and during GF between the genders (p > 0.05). The results suggest that the change in daily PA levels by females is a consequence of increased MVPA during GF and reduced PA barriers across the season.