Relieving the pressure? The role of physical activity in the relationship between school-related stress and adolescent health complaints

Influence of multiple risk behaviors on physical activity-related injuries in adolescents

OBJECTIVE

The study objectives were to (1) examine the relationship between physical activity and physical activity injuries in youth, (2) determine whether this relationship is modified by the engagement in multiple risk behaviors, and (3) determine whether this relationship is modified by the setting of the injury (school versus outside of school).

METHODS

We examined associations between physical activity and multiple risk behaviors with physical activity injuries occurring at and outside of school. The study population consisted of a representative sample of 5559 Canadian youth in grades 6 through 10 who participated in the 2001/2002 Health Behavior in School-Aged Children Survey. The exposure and outcome measures were determined from a classroom-based survey.

RESULTS

Irrespective of grade, there were strong gradient relations between physical activity participation and related injuries outside of school. Conversely, there were modest relations between physical activity participation and related injuries at school. In students in grades 6 to 8, there was no relation between multiple risk behaviors and physical activity injuries at school and a curvilinear relation between multiple risk behaviors and physical activity injuries outside of school. The opposite pattern of relationships between multiple risk behaviors and injuries was observed in students in grades 9 to 10. Irrespective of grade and setting of injury, there was no significant interaction between physical activity and multiple risk behaviors on injury risk. The results were consistent by severity of injury and for structured/organized and unstructured/informal forms of physical activity.

CONCLUSIONS

The environment moderated the relation between physical activity and related injuries in that strong risk gradients only existed outside of the school setting. Unexpectedly, there were no consistent gradients between the engagement in multiple risk behaviors and physical activity injuries or any interaction effect between physical activity exposure and multiple risk behaviors. These findings suggest that optimizing the environment would be a preferred strategy for preventing physical activity injuries compared with selectively targeting youth who engage in multiple risk behaviors.

Effects of a classroom-based program on physical activity and on-task behavior

PURPOSE

This study evaluated the effects of a classroom-based physical activity program on children's in-school physical activity levels and on-task behavior during academic instruction.

METHODS

Physical activity of 243 students was assessed during school hours. Intervention-group students (N = 135) received a classroom-based program (i.e., Energizers). The control group (N = 108) did not receive Energizers. On-task behavior during academic instruction time was observed for 62 third-grade (N = 37) and fourth-grade students (N = 25) before and after Energizers activities. An independent groups t-test compared in-school physical activity levels between intervention and control classes. A multiple-baseline across-classrooms design was used to evaluate the effectiveness of the Energizers on on-task behavior. Additionally, a two-way (time [pre- vs postobservation] x period [baseline vs intervention]) repeated-measures analysis of variance compared on-task behavior between observation periods. Magnitudes of mean differences were evaluated with Cohen's delta (ES).

RESULTS

Students in the intervention group took significantly (P < 0.05) more in-school steps (5587 +/- 1633) than control-group students (4805 +/- 1543), and the size of this difference was moderate (ES = 0.49). The intervention was effective in improving on-task behavior; after the Energizers were systematically implemented, on-task behavior systematically improved. The improvement in on-task behavior of 8% between the pre-Energizers and post-Energizers observations was statistically significant (P < 0.017), and the difference was moderate (ES = 0.60). Likewise, the least on-task students improved on-task behavior by 20% after Energizers activities. This improvement was statistically significant (P < 0.001) and meaningful (ES = 2.20).

CONCLUSION

A classroom-based physical activity program was effective for increasing daily in-school physical activity and improving on-task behavior during academic instruction.

Risk taking and recurrent health symptoms in Canadian adolescents

OBJECTIVE

Psychosomatic health symptoms are commonly experienced by young people and are associated with chronic health problems. This study examines reports of psychosomatic health symptoms during adolescence, and associations between adolescent risk-taking and the occurrence of these symptoms.

METHOD

A cross-sectional national health survey was performed in 2001/02 and involved 1746 young Canadians. Principal components analyses were used to derive a multiple risk-taking score. Multi-level regression models with individual participants (1st level) nested in schools (2nd level) were used to examine associations between individual then multiple risk-taking behaviors and psychosomatic symptoms.

RESULTS

37% of males and 48% of female students reported psychological health symptoms > once per week, while 30% of males and 41% of females reported somatic health symptoms. Strong associations were observed between individual risk-taking behaviors (cannabis use, other illicit drug use, drunkenness, smoking, unprotected sex) and psychosomatic health symptoms. A risk gradient was observed between multiple risk behaviors and these health symptoms. Youth who engaged in high levels of risk-taking behavior were two to four times more likely to report health symptoms.

CONCLUSION

Adolescent lifestyles that include risk-taking behavior are strongly associated with the occurrence of psychosomatic health symptoms. Collectively, these measures are useful clinical indicators of adolescent health status.

Positive factors associated with promoting health in low-risk and high-risk populations of 15- and 16-year-old pupils in Oslo, Norway

AIM

To explore possible risk-reducing factors associated with the incidence of common illnesses and use of healthcare services among adolescents.

METHODS

Cross-sectional questionnaire study conducted in all Oslo schools among all 15- and 16-y-olds in 2000 and 2001. The adolescent population was divided into a low-risk (LR) and a high-risk (HR) group, and into quartiles, based on a sum score of different negative life experiences. The groups were compared with respect to potential risk-reducing factors.

RESULTS

88% of the 8316 pupils filled in the questionnaires. The difference between the LR and HR groups was largest for the possible risk-reducing factor "my family values my opinion" (LR group = 92%; HR group = 82%), and "I manage to solve serious problems myself" (LR = 91%; HR = 86%). The family valuing the adolescents' opinions was the risk-reducing factor most often associated with lower incidences of illness and healthcare utilization. Among the adolescents at highest risk, less depression was strongly related to positive relationships with friends, boys: odds ratio = 0.1 (CI 95%: 0.0-0.7); and girls: 0.2 (0.1-0.5). Adolescents reporting that they managed their own problems had about half the risk of depression.

CONCLUSION

Good relations with family and friends, and a feeling of managing one's own life, are significantly related to lower rates of illness, in particular depression, and less healthcare-seeking behaviour. The risk-reducing effects increase with increasing risk. Healthcare workers therefore need to pay more attention to HR patients.