Influences of social support, perceived barriers, and negative meanings of physical activity on physical activity in middle school students

The impact of multiple supports on university students' physical education learning motivation: a dual analysis based on SEM and fsQCA

Background

During their physical education courses, university students may encounter various academic pressures and difficulties, which significantly undermine their physical education learning motivation and affect their overall development. Multiple supports from teachers, parents, and peers can effectively help students maintain confidence and enhance their physical education learning motivation. However, the underlying mechanisms by which these multiple supports influence motivation for physical education remain unclear.

Objective

This study aims to explore the underlying mechanisms by which multiple supports influence learning motivation during physical education, specifically examining the mediating roles of self-efficacy and positive coping style. Additionally, it seeks to elucidate the complex configurational relationships among multiple supports, self-efficacy, coping style, and physical education learning motivation.

Methods

This study employs a cross-sectional survey method to investigate Chinese university students. Through convenience sampling, 969 students were recruited from four universities in Shandong Province. The participants completed the Teacher Support Scale, Parent Support Scale, Peer Support Scale, Self-Efficacy Scale, Positive Coping Style Scale, and Learning Motivation Scale. For data analysis, statistical processing was conducted using SPSS 26.0, Amos 22.0, and fsQCA 4.1.

Results

The results indicate that multiple supports from teachers, parents, and peers have significant direct effects on individual physical education learning motivation, with effect sizes of 0.132, 0.090, and 0.237, respectively. Self-efficacy acts as an independent mediator between multiple supports and physical education learning motivation, with effect sizes of 0.111, 0.076, and 0.197, respectively. Positive coping style also serve as an independent mediator in these relationships, with effect sizes of 0.091, 0.019, and 0.072; Self-efficacy and positive coping style function as a chain mediating mechanism between multiple supports and physical education learning motivation, with effect sizes of 0.021, 0.015, and 0.038; There are five equivalent configurations identified among multiple supports, self-efficacy, coping style, and physical education learning motivation.

Conclusion

Support from teachers, parents, and peers not only directly influences students' physical education learning motivation but also indirectly predicts students' physical education learning motivation through the independent and chain mediating roles of self-efficacy and coping style. Additionally, this study elucidates the complex configurational relationships among multiple supports, self-efficacy, coping style, and physical education learning motivation, thereby validating and supplementing the results of linear analysis.

Physical activity, weight management, and mental health during COVID-19 lockdown: A cross-sectional study of healthcare students in China

BACKGROUND

There is growing evidence that the social blockade brought about by the COVID-19 pandemic has dramatically affected college students' physical activity; however, their weight management behaviors and mental health have not been fully explored, especially among healthcare students. This study aimed to assess physical activity, weight management behaviors, and mental health among healthcare students during the campus lockdown and to analyze the factors influencing physical activity.

METHODS

A cross-sectional survey of 1,216 healthcare students from March 24, 2022, to April 11, 2022. To collect information about students' physical activity, weight management behaviors, and mental health, they were asked to complete the Physical Activity Questionnaire-Short Form (IPAQ-SF), 11 issues related to weight management behavior, and the World Health Organization 5-Item Well-Being Index (WHO-5) questionnaire. Binary logistic regression was performed to determine the factors influencing physical activity.

RESULTS

Almost half of the participants had low levels of physical activity (45%), the mean score for weight management behavior was 39.55±6.26, and 54.6% had low levels of well-being. Healthcare students without exercise habits during the non-epidemic period reported lower levels of physical activity (OR = 1.81; 95%CI = 1.41-2.34, P<0.001). Participants with poor weight management behavior were more likely than other participants to report lower levels of physical activity (OR = 0.92; 95%CI = 0.90-0.94, P < 0.001). Likewise, the odds of being physically inactive were higher among the happier participants (OR = 0.98; 95%CI = 0.96-0.99, P = 0.031).

CONCLUSIONS

During the COVID-19 lockdown, most healthcare students in Gansu province lack physical exercise and have a low health level. Significant correlation factors for low physical activity levels were grade level, non-lockout exercise habits, weight management level, and well-being. These findings demonstrate the importance of developing targeted policies and programs encouraging physical activity among medical students.

How does psychological capital lead to better well-being for students? The roles of family support and problem-focused coping

Recent studies have shifted the attention on the beneficial role of psychological capital from workplace to academic contexts. Moreover, the mediating role of psychological capital in the effect of social support on student outcomes remains unknown. This topic has become more imperative under the pandemic. The current study aimed to investigate the impact of psychological capital on students' well-being with family support as an antecedent and problem-focused coping as a mediator. Two hundred and eighty-one students completed the questionnaire at two time points. Results of the cross-lagged mediation analysis showed that family support positively predicted psychological capital, psychological capital positively predicted problem-focused coping, and problem-focused coping predicted well-being. Moreover, the chain mediation path between family support and well-being via psychological capital and problem-focused coping was significant. The current findings identify the antecedent and underlying mechanism behind the relationship between psychological capital and well-being, providing insights into psychological capital interventions for students.

Barriers to high school and university students' physical activity: A systematic review

Physical inactivity commonly occurs throughout one's life, particularly during adolescence and young adulthood. Multiple factors can negatively influence participation in physical activity, but there has been no review examining the barriers to physical activity among high school and university students. Therefore, the aim of this systematic review was to summarize evidence of barriers to the practice of physical activity among high school and university students. The literature search was conducted without time limits using five databases, including CINAHL, Cochrane Library, Embase, PubMed, and Scopus. In total, 59 studies (37 with high school students [n = 22,908] and 22 with university students [n = 15,411]) were included. The main barriers identified in high school and university students were lack of time, lack of motivation, and lack of accessible places. These findings may be useful in designing and implementing evidence-informed interventions and programs for physical activity promotion in students.

Applying Social Cognitive Theory in Predicting Physical Activity Among Chinese Adolescents: A Cross-Sectional Study With Multigroup Structural Equation Model

This cross-sectional study aimed to assess the applicability of social cognitive determinants among the Chinese adolescents and examine whether the predictability of the social cognitive theory (SCT) model on physical activity (PA) differs across gender (boys and girls) and urbanization (urban and suburban). A total of 3,000 Chinese adolescents ranging between the ages of 12-15 years were randomly selected to complete a set of questionnaires. Structural equation modeling (SEM) was applied to investigate the relationships between social cognitive variables and PA in the urbanization and gender subgroups. The overall model explained 38.9% of the variance in PA. Fit indices indicated that the structural model of SCT was good: root mean square error of approximation (RMSEA) = 0.047, (root mean square residual) RMR = 0.028, goodness of fit index (GFI) = 0.974, adjusted goodness of fit index (AGFI) = 0.960, Tucker-Lewis coefficient (TLI) = 0.971, and comparative fit index (CFI) = 0.978. Regarding the subgroup analysis, social support (critical ratios [CRs] = 2.118; p < 0.001) had a more substantial impact on the PA of adolescents in suburban areas than that in urban areas, whereas self-regulation (CRs = -2.896, p < 0.001) had a more substantial impact on the PA of adolescents in urban areas than in suburban areas. The results indicate that the SCT model predicts the PA of Chinese adolescents substantially. An SCT model could apply over a range of subgroups to predict the PA behavior and should be considered comprehensively when designing interventions. These findings would benefit PA among the Chinese adolescents, especially across genders and urbanization.

Disambiguating Between Privacy and Security in the Context of Health Care: New Insights on the Determinants of Health Technologies Use

Health care providers are increasingly providing technologies for patient care; however, patients are still loath to use such technologies consistently. This research examines the impediments to patients' use of e-health portals. Our analysis of 836 data records showed that while privacy and security concerns have a negative impact on attitudes toward e-health portals, increasing the awareness of privacy and security controls alleviates such concerns. Our findings also suggest that individuals worry more about who possesses the right to access their health data (i.e., who, what, when, and why) than the mechanisms used to safeguard data from unauthorized access. We found that perceived benefits and support (i.e., emotional and technical support) positively influenced the determinants of use intentions. The implications of these findings for health care providers and policy makers are discussed.

Social Network Analysis in Child and Adolescent Physical Activity Research: A Systematic Literature Review

BACKGROUND

Regular physical activity (PA) has many benefits for children and adolescents, yet many do not meet PA recommendations. Social context is important for promoting or discouraging PA among children and adolescents. This review aimed to identify social network variables related to PA among children and adolescents.

METHODS

A systematic review of the literature was conducted in September 2018 using PsycINFO, MEDLINE, PubMed, and Web of Science. Included articles needed to (1) be focused on children (aged 5-11 y) or adolescents (aged 12-17 y), (2) include a measure of PA, (3) include a measure of egocentric or sociocentric social connection in which alters were nominated, and (4) perform an analysis between network data and PA.

RESULTS

A search of 11,824 articles was refined to a final sample of 29 articles. Social network themes and concepts such as homophily, centrality, and network composition were related to child and adolescent PA behavior across the literature.

CONCLUSIONS

The impact of an individual's social network is evident on their PA behaviors. More research is needed to examine why these networks form in relation to PA and how interventions can utilize social network analysis to more effectively promote PA, especially in underserved and minority populations.

Associations Among Physical Education, Activity-Related Healthy Lifestyle Practices, and Cardiorespiratory Fitness of Chinese Youth

PURPOSE

Physical education (PE) in school provides opportunities for physical activity (PA) engagement and reportedly results in improved health-related fitness. This study explored the underlying correlations between PE and activity-related healthy lifestyle practices with current level of cardiorespiratory fitness.

METHODS

A total of 13,138 students age 14 (boys = 7,094, 54.0%) in Grade 8 from the China National Assessment of Educational Quality - Physical Education & Health 2015 were included in this study. Two independent structural equation modeling (SEM) analyses were conducted to obtained sex-specific results. Data included the results of the 15-m progressive aerobic cardiovascular endurance run (PACER) and questionnaire data regarding PE curriculum implementation, learning and practice, perceived support from PE teachers, PE facilities, PE equipment, activity-related healthy lifestyle practices, habitual physical fitness, appropriate method of physical fitness, and breakfast eating habits. Structural equation modeling was applied to examine the associations between variables, controlling for socioeconomic status, the location of schools, and Body Mass Index.

RESULTS

There was a statistically significant relationship between cardiorespiratory fitness and activity-related healthy lifestyle practices, which was somewhat positively impacted by skill learning and practice and perceived support from PE teachers. Together, the boy's model explained 21.8% of the variance in cardiorespiratory fitness, whereas the girl's model explained 15.9%.

CONCLUSIONS

A well-organized PE program is related to students' activity-related healthy lifestyle practices, and consequently provides an improvement to cardiorespiratory fitness.

Physical activity, social support and socio-economic status amongst persons living with HIV and AIDS: a review

Physical activity can be used for the effective and comprehensive management of HIV and AIDS. Social support and socio-economic status (SES) are two factors that shape physical activity behaviours. Individuals of low SES carry a disproportionate burden of the HIV and AIDS epidemic. In addition, limited resources constitute socio-ecological barriers predisposing such individuals to physical inactivity. The purpose of this narrative review is to examine the available literature on physical activity, social support and SES and to generate recommendations for designing and implementing physical activity interventions targeting people living with HIV and AIDS (PLWHA) of low SES. The review used literature from Google, Google Scholar and PubMed on physical activity of PLWHA, social support for physical activity, and SES and physical activity. Qualitative and quantitative studies in English were included from 1970 to 2016. The results show that social support plays a major role in promoting physical activity and counteracting the barriers to PA in PLWHA of low SES. The results on the role of social support and the influence of SES are integrated to help design appropriate physical activity interventions for PLWHA of low SES. Well-designed interventions should utilise social support and be contextualised for PLWHA of low SES, whose living conditions present multiple barriers to physical activity.

A Dyadic Analysis on Source Discrepancy and a Mediation Analysis via Self-Efficacy in the Parental Support and Physical Activity Relationship among Black Girls

BACKGROUND

Physical activity (PA) declines in adolescence among black girls. This study assesses how moderate/vigorous physical activity (MVPA) relates to caregiver- vs. adolescent-reported parental support and whether the relationship is mediated by self-efficacy.

METHODS

MVPA was assessed through accelerometry. Parental support and encouragement on adolescents' PA were reported by caregivers and adolescents with a 10-item Social Support and Exercise Survey. Adolescent-reported self-efficacy related to PA was assessed with an 8-item scale. Structural equation modeling assessed source variation (caregiver vs. adolescent report) in the relationship between parental support and MVPA and mediation through adolescent self-efficacy.

RESULTS

The sample includes black adolescent girls (n = 272), with mean age of 11.6 years (standard deviation = 0.7), and average MVPA/day of 40.6 minutes. Caregiver/adolescent agreement on parental support was low (weighted Kappa <0.20). There was significant source variation in the parental support-MVPA relationship (Wald χ² = 4.18, df = 1, p = 0.041); adolescent-reported support was related to MVPA (b = 0.40, standard error = 0.14, p = 0.003) and mediated through self-efficacy (95% bootstrapped confidence interval: 0.05-0.29). Caregiver-reported support or BMI z-score was not related to MVPA.

CONCLUSIONS

The association between MVPA and adolescent-reported parental support among black adolescent girls is explained by positive self-efficacy. Findings suggest that effective adolescent/caregiver communication around parental support on PA relates to high adolescent self-efficacy and supports objectively measured PA. Additional research is merited to examine longitudinal patterns. Furthermore, although 51.5% of girls in the sample were overweight or obese, the lack of association between MVPA and body composition minimizes its implication for mitigating obesity among overweight/obese black adolescent girls.

Social Status and Adolescent Physical Activity: Expanding the Insurance Hypothesis to Incorporate Energy Expenditure

Low social status (SS) is a determinant of poor health status and is associated with increased disease burden. Obesity affects 20.6% of American adolescents, most of whom are from low-SS families. Contributors to the development of obesity among adolescents include sedentary behavior and low levels of physical activity. Environmental determinants-infrastructure, policy, and social relationships-influence engagement in physical activity and are affected by SS. Significant declines in physical activity have been documented during adolescence, and adolescents of low SS engage in significantly less physical activity per week than those with high SS. This article briefly reviews the literature on the relationship between SS and physical activity in adolescents and introduces a proposed biological mechanism that may explain that relationship. Characterizing the effects that SS can have on physical activity may help tailor clinical interventions and public health campaigns seeking to improve adolescent physical activity and weight management, thus increasing their effectiveness. This may be particularly beneficial for underserved populations.

Association between socio-economic status and physical activity is mediated by social support in Brazilian students

This study evaluated whether the relationship between socioeconomic status (SES) and moderate-to-vigorous physical activity (MVPA) is mediated by social support of peers and parents. A cross-sectional study included students (n = 1182) aged 11 to 18 years who were recruited in 2014 from public schools in Fortaleza, Brazil. Participants completed a questionnaire to assess all variables. Mediation analyses were performed to determine the role of parental support and peer support on the relationship between SES and MVPA. Also, moderated-mediation analyses with estimating of conditional indirect effects were performed in order to identify whether gender is a moderator of the mediating effect. A positive and significant association between SES and MVPA was found among Brazilian students, and social support of parents and peers were significant mediators of this relationship. Conditional indirect effects showed that both parental and peer support had a significant indirect effect among boys; only parental support had a significant indirect effect among girls. These results suggest that improving social support can help reduce the impact of SES on physical activity among Brazilian adolescents.

The Feasibility of a Novel School Peer-Led Mentoring Model to Improve the Physical Activity Levels and Sedentary Time of Adolescent Girls: The Girls Peer Activity (G-PACT) Project

Regular physical activity (PA) is associated with numerous physical and psychological health benefits. Adolescents, specifically girls, are at risk of physical inactivity. To date, there is limited research on PA interventions involving peers, which could encourage more adolescent girls to engage in PA. The investigation aimed to evaluate the feasibility of a novel school three-tier peer-led mentoring model designed to improve PA levels and reduce sedentary time (ST) of adolescent girls. Two-hundred and forty-nine Year 9 adolescent girls (13⁻15 years old) from three UK secondary schools were invited to participate in a peer-led mentoring intervention (Girls Peer Activity (G-PACT) project). The peer-led mentoring model was delivered in all three schools. Two of the schools received an additional after-school PA component. PA and ST were assessed through wrist-worn accelerometry. Girls who received an exercise class after-school component significantly increased their whole day moderate-to-vigorous PA (MVPA) (3.2 min, p = 0.009, d = 0.33). Girls who received no after-school component significantly decreased their MVPA (3.5 min, p = 0.016, d = 0.36) and increased their ST (17.2 min, p = 0.006, d = 0.43). The G-PACT intervention demonstrated feasibility of recruitment and data collection procedures for adolescent girls. The peer-led mentoring model shows promise for impacting girls' MVPA levels when combined with an after-school club PA opportunity.

Physical activity and screen-based recreation: Prevalences and trends over time among adolescents and barriers to recommended engagement

Adolescence is a critical time for disengagement from physical activity making young people a priority group for interventions. To determine whether existing initiatives are working in this population segment and help inform future programs, the present study sought to (i) examine prevalences and trends in physical activity and screen-based recreation among Australian adolescents and (ii) identify the barriers to adolescents meeting recommended guidelines. Two cross-sectional representative samples of Western Australian secondary school students aged 12 to 17years were surveyed in 2009-2010 (n=1505) and 2012-2013 (n=1406). Around a quarter (24%) of boys and just 9% of girls reported engaging in the recommended 60min of physical activity per day in 2012-2013. A minority (13% of boys, 17% of girls) adhered to guidelines for time spent engaging in screen-based recreation (≤2h of electronic media use for entertainment). These findings were comparable to 2009-2010 prevalence levels. Multivariable logistic regression analyses conducted on data from the most recent wave found individual-level barriers to be significantly associated with lower odds of meeting physical activity guidelines in both boys (Adj. OR=0.52, 95% CI=0.38, 0.72) and girls (Adj. OR=0.41, 95% CI=0.25, 0.66). The consistently high proportion of adolescents not meeting physical activity recommendations over time suggests that current efforts to increase physical activity may be failing to have an impact on population-level trends in compliance. While initiatives to improve the built environment may reduce barriers at the environmental level, these initiatives risk having little impact on physical activity if individual level barriers remain unaddressed.

Effect of an obesogenic environment and health behaviour-related social support on body mass index and body image of adolescents

Aim:

The purpose of this study was to examine the effect of an obesogenic environment and social support for health behaviours on body mass index and body image in adolescents.

Methods:

This methodological and descriptive study was conducted in a city centre in Turkey. Interviews were made with the Provincial Directorate for National Education, and the schools in the city centre were divided into three regions according to socioeconomic levels; three schools were then determined among the regions by drawing lots. The data collection was performed with 270 students randomly selected from the three schools. A student information form, an obesogenic environment evaluation form, body cathexis scale, body mass index (BMI) and the Child and Adolescent Social Support Scale for Healthy Behaviours were used to collect data. Percentage distributions, correlations, chi-square tests, analyses of variance and independent samples t-tests were used in the data analysis.

Results:

According to the data acquired, 10.7% of adolescents in the study group were overweight and 3.0% were obese. There was a positive relationship between the obesogenic environment and BMI, and as the obesogenic environmental features of adolescents increased, the BMI increased, and the body image scores decreased. As social support for the adolescents’ health behaviours increased from their mothers, fathers, teachers, classmates, and close friends, BMI decreased and they were more likely to be satisfied satisfied with their bodies.

Conclusion:

Our results demonstrate that, while an obesogenic environment contributed to increased BMI in adolescents and decreased their body satisfaction, social support given for health behaviours had a positive effect on BMI and body perception.

Psychometric Evaluation of Three Psychosocial Measures Associated With Physical Activity Among Adolescent Girls

The purpose of this study was to evaluate the psychometric properties of a Perceived Benefits Scale, a Perceived Barriers Scale, and a Physical Activity Enjoyment Scale with data from a group randomized controlled trial (RCT) and a test-retest study with 1-week interval. In the group RCT at baseline and Week 17, 1,012 fifth- to eighth-grade girls completed an iPad-delivered survey and wore 7-day accelerometers measuring moderate-to-vigorous physical activity (MVPA). In the test-retest study, 91 fifth- to seventh-grade girls completed the iPad-delivered survey at Times 1 and 2. Benefits, barriers, and enjoyment scales had Cronbach's αs of .75, .86, and .78 and test-retest reliability of .83, .88, and .79, respectively. Benefits Scale had a two-factor structure (physical and psychosocial benefits), while the remaining two had a one-factor structure indicating construct validity. Barriers ( r = -.16) and enjoyment ( r = .17) were correlated with MVPA indicating concurrent validity. Baseline MVPA and psychosocial benefits positively, while physical benefits negatively, predicted MVPA at Week 17 indicating predictive validity. The measures demonstrated satisfactory psychometric properties.

Physical Activity Self-Efficacy and Fitness: Family Environment Relationship Correlates and Self-Esteem as a Mediator among Adolescents Who Are Overweight or Obese

BACKGROUND

Little is known regarding how dimensions of the family social environment relate to fitness levels and physical activity self-efficacy (PASE) among adolescents who are overweight or obese and whether these relationships are mediated by self-esteem.

METHODS

Potential associations were evaluated between relationship subdomains (cohesion, conflict, expressivity) of the Family Environment Scale (FES), self-esteem (Rosenberg Self-Esteem Scale, RSES), and PASE and fitness, using recovery heart rate [RHR, beats per minute (bpm)] from a 3-minute submaximal step test at baseline. Participants were 108 adolescents who were overweight or obese and were seeking weight-loss treatment as part of the Healthy Kids, Healthy Weight 12-week multidisciplinary pediatric weight management program. Structural equation modeling (SEM) was used to simultaneously evaluate paths between these variables and test for mediation.

RESULTS

In multivariable models, higher FES cohesion (β = -2.18, s.e. = 0.98; p = 0.02), expressivity (β = -1.97, s.e. = 0.99; p < 0.05), and PASE (β = -0.64, s.e. = 0.33; p < 0.05) scores were associated with lower RHR, which represents higher fitness. Furthermore, higher FES conflict scores were associated with lower RSES scores (β = -0.83, s.e. = 0.29; p < 0.01), and FES conflict (β = -0.63, s.e. = 0.22; p < 0.01) and RSES (β = 0.33, s.e. = 0.07; p < 0.01) were associated with PASE scores. In a good-fitting multivariate SEM [Comparative Fit Index (CFI) = 1.00; Standardized Root Mean Square Residual (SRMR) = 0.02; Tucker-Lewis index (TLI) = 1.22; Root Mean Squared Error of Approximation (RMSEA) <0.01], RSES mediated the relationship between FES conflict and PASE (sum of indirect paths: β = -0.30, s.e. = 0.11; p < 0.01) scores.

CONCLUSIONS

Our results highlight the importance of the relationship domain of the family environment on self-esteem, PASE, and physical fitness in adolescents who are overweight or obese.

Mediating Effects of Self-Efficacy, Benefits and Barriers on the Association between Peer and Parental Factors and Physical Activity among Adolescent Girls with a Lower Educational Level

Background

The prevalence of physical activity among lower educated adolescent girls is low, suggesting it is important to have insights into the complex processes that may underlie their physical activity levels. Therefore, this study aimed to examine the mediating effects of self-efficacy, perceived benefits and barriers on the associations between peer and parental variables and physical activity among lower educated adolescent girls.

Methods

In total, 226 girls (mean age 16.0±1.0 years; 53% technical education; 47% vocational education) from a convenience sample of 6 secondary schools in Flanders, Belgium, completed a questionnaire on their total physical activity level and related peer and parental variables (i.e. modeling of physical activity, co-participation in physical activities and encouragement to be active) and personal variables (i.e. self-efficacy to be active, and specific perceived benefits of physical activity and specific barriers to be active). Mediating effects were tested using MacKinnon’s product-of-coefficients test based on multilevel linear regression analyses.

Results

Higher peer and parental modeling, co-participation and encouragement were significantly related to a higher physical activity level among adolescent girls (p<0.05). Self-efficacy, the perceived benefits of having fun, being around friends or meeting new people, and not being bored and the perceived barrier of not liking physical activity mediated several associations between peer and parental variables and girls’ physical activity, with some of the mediated proportions exceeding 60%.

Conclusions

This study contributed to a better understanding of the complexity of how parental and peer factors work together with personal factors to influence the physical activity levels of adolescent girls with a lower educational level. Interventions should involve both peers and parents, as they may influence girls’ physical activity both directly and indirectly through the internalisation of several personal variables, such as self-efficacy to be active and the perceived benefit of having fun.

Physical activity and screen-time of childhood haematopoietic stem cell transplant survivors

AIM

Reduced bone mineral density, impaired cardiovascular fitness and increased risk of obesity are well-known late effects of haematopoietic stem cell transplantation (HSCT) in survivors of childhood cancer. These comorbidities can be mitigated through physical activity and limiting screen-time (ST). This study aims to increase the understanding of physical activity and ST behaviours for children following HSCT.

METHODS

Children were recruited from two oncology follow-up clinics and completed a questionnaire on their physical activity levels and screen-time. Children were classified as short (≤2 years) and long-term (>2 years) survivors.

RESULTS

Fifty-eight children were eligible, of whom forty children of age 6-18 years (60% males) participated in the study. Less than half (47.5%) met the daily recommendations for physical activity and one-third met the ST recommendations. Late survivors reported higher daily physical activity and less ST than early survivors. Among late survivors, females reported higher daily physical activity and less ST than males.

CONCLUSION

Our findings suggest that the majority of children following HSCT were not sufficiently active and had excessive screen-time; however, this was comparable to healthy populations. Appropriately designed physical activity and screen-time intervention programmes should be explored early following transplant for children undergoing HSCT.

Family Cohesion and Moderate-to-Vigorous Physical Activity Among Mexican Origin Adolescents: A Longitudinal Perspective

BACKGROUND

Existing racial/ethnic disparities in physical activity during childhood increase Hispanics' risk of developing chronic diseases, which serves to increase health disparities. This study examined associations of family cohesion and conflict with self-reported moderate-to-vigorous physical activity (MVPA), controlling for psychosocial covariates such as subjective social status, anxiety, and sensation-seeking.

METHODS

1000 Mexican origin adolescents reported their MVPA levels approximately 2 years apart. Psychosocial covariates, family cohesion and conflict were measured at the first assessment. Generalized Linear Models were used to prospectively examine the relationship between family cohesion and conflict and subsequent MVPA based on 711 participants who had low levels of baseline MVPA.

RESULTS

35% of boys and 24% of girls reported adequate MVPA levels at follow-up; girls were less likely to report adequate MVPA (RR = 0.76; 95% CI: 0.61-0.93) than boys. Overall, family cohesion was associated with MVPA (P = .01), but family cohesion was not (P = .41). Gender-based analyses revealed that adequate MVPA was associated with family cohesion (RR = 1.40; 95% CI: 1.03-1.88), sensation seeking (RR = 1.05; 95% CI: 1.00-1.10), and age (RR = 0.85; 95% CI: 0.74-0.98) among girls and with subjective social status (RR = 1.20; 95% CI: 1.08-1.33) among boys.

CONCLUSIONS

The family social environment and gender differences should be addressed in health promotion programs targeting MVPA.

Social support and peer norms scales for physical activity in adolescents

OBJECTIVES

To evaluate psychometric properties of a Social Support and Peer Norms Scale in 5th-7th grade urban girls.

METHODS

Baseline data from 509 girls and test-retest data from another 94 girls in the Midwestern US were used.

RESULTS

Cronbach's alpha was .83 for the Social Support Scale and .72 for the Peer Norms Scale, whereas test-re-test reliability was .78 for both scales. Exploratory factor analysis suggested a single factor structure for the Social Support Scale, and a 3-factor structure for the Peer Norms Scale. Social support was correlated with accelerometer-measured physical activity (r = .13, p = .006), and peer norms (r = .50, p < .0001).

CONCLUSIONS

Both scales have adequate psychometric properties.

Validity and reliability of questionnaires measuring physical activity self-efficacy, enjoyment, social support among Hong Kong Chinese children

Background

Physical activity (PA) correlates have not been extensively studied in Hong Kong children.

Objective

The aim of this study is to assess the validity and reliability of translated scales to measure PA related self-efficacy, enjoyment and social support in Hong Kong Chinese children.

Methods

Sample 1 (n = 273, aged 8–12 years) was recruited (May–June, 2013) from two primary schools. Confirmatory factor analyses (CFA) were conducted to assess factorial validity. Criterion validity was assessed by correlating measured constructs with self-reported PA. Cronbach's alpha was computed to assess scale internal consistency. The intraclass correlation coefficient (ICC) was performed to assess scale test–retest reliability. Criterion validity was further examined in Sample 2 (n = 84, aged 8–12 years) from a third school by correlating measured constructs with objectively measured PA collected in September 2013 and February 2014.

Results

The CFA results supported the one-factor structure of the scales. All PA correlates were significantly (p < 0.01) associated with self-reported PA in Sample 1. Self-efficacy and enjoyment were significantly (p < 0.05) correlated with objectively measured PA in Sample 2. All the scales demonstrated acceptable internal consistency. All ICC values of the scales suggested acceptable test–retest reliability.

Conclusion

The results provide psychometric support for using the scales to measure PA correlates among Hong Kong Chinese children.

•

Validity and reliability of translated scales measuring PA correlates were assessed among Hong Kong children.

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Confirmatory factory analyses supported the scale factorial validity.

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Scale criterion validity was supported by significant correlation between each construct with self-reported PA.

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Scale internal consistency and test-rest reliability were all acceptable.

•

Scale criterion validity (self-efficacy and enjoyment) was further demonstrated with objectively measured physical activity in a smaller sample.

Physical activity and social support in adolescents: a systematic review

The objective of this review was to systematically synthesize the results of original studies on the association between physical activity and social support in adolescents, published until April 2011. Searches were carried out in Adolec, Eric, Lilacs, Medline, SciELO, Scopus, SportsDiscus and Web of Science electronic databases and the reference lists of selected articles. Searches for articles, data extraction and assessment of methodological quality were conducted independently by two reviewers. In total, 75 articles met inclusion criteria and were analyzed. Most studies were published over the past 6 years (2006-11), conducted in high-income countries, with a cross-sectional design, using subjective measures of physical activity (e.g. questionnaires and recall) and exhibited medium to high methodological quality level. Social support was positive and consistently associated with the physical activity level of adolescents in cross-sectional and longitudinal studies. Those who received more overall social support as well as support from both parents, friends and family showed higher levels of physical activity. It is concluded that social support is an important factor associated with physical activity level in adolescents and should be targeted in intervention programs that aim to increase physical activity levels in this population group.

Influence of friends on children's physical activity: a review

We examined evidence for friendship influences on children's physical activity (PA) through systematic searches of online databases in May 2012. We identified 106 studies (25 qualitative) published in English since 2000 that analyzed indicators of friendship influences (e.g., communication about PA, friends' PA, and PA with friends) among persons younger than 19 years. Children's PA was positively associated with encouragement from friends (43 of 55 studies indicating a positive relationship), friends' own PA (30/35), and engagement with friends in PA (9/10). These findings are consistent with friends influencing PA, but most studies did not isolate influence from other factors that could explain similarity. Understanding friendship influences in childhood can facilitate the promotion of lifelong healthy habits. PA with friends should be considered in health promotion programs.

Family support and ease of access link socio-economic status and sports club membership in adolescent girls: a mediation study

BACKGROUND

Much research has been conducted into the determinants of physical activity (PA) participation among adolescent girls. However, the more specific question of what are the determinants of particular forms of PA participation, such as the link between participation through a sports club, has not been investigated. Accordingly, the aim of this study was to investigate the relationships between participation in a sports club and socio-economic status (SES), access to facilities, and family and peer support, for female adolescents.

METHODS

A survey of 732 female adolescent school students (521 metropolitan, 211 non-metropolitan; 489 Year 7, 243 Year 11) was conducted. The survey included demographic information (living arrangements, ethnicity indicators, and indicators of SES such as parental education and employment status and locality); access to facilities; and family and peer support (travel, encouragement, watching, praise, joint participation). For each characteristic, sports club participants and non-participants were compared using chi-square tests. Multiple mediation analyses were used to investigate the role of access, family and peer support in the link between SES and sport participation.

RESULTS

There were significant associations (p<0.05) between sports club participation and: all demographic characteristics; all measures of family and peer support; and access to sport-related facilities. Highest levels of participation were associated with monolingual Australian-born families, with two parents, at least one of whom was well-educated, with both parents employed, and high levels of parental assistance, engagement and support. Participation in club sport among both younger and older adolescent girls was significantly positively associated with the SES of both their neighbourhoods and their households, particularly in metropolitan areas. These associations were most strongly mediated by family support and by access to facilities.

CONCLUSIONS

To facilitate and promote greater participation in club sport among adolescent girls from low SES neighbourhoods and households, strategies should target modifiable determinants such as facility access and parental support. This will involve improving access to sports facilities and promoting, encouraging and assisting parents to provide support for their daughters' participation in sport clubs.

Do psychosocial factors moderate the association between neighborhood walkability and adolescents' physical activity?

Ecological models emphasize the interaction between individuals and their environment. Furthermore, they posit that environmental variables influence physical activity (PA) not only directly but also indirectly through their interaction with other factors. This study explored if the association between neighborhood walkability and adolescents' PA is moderated by psychosocial factors using data from the Belgian Environmental PA Study in Youth (BEPAS-Y). BEPAS-Y recruited adolescents from 32 neighborhoods differing in objectively determined neighborhood walkability and income. Between 2008 and 2009, 637 adolescents (13-15 years; 49.4% boys) completed a survey measuring socio-demographic and psychosocial factors and wore an accelerometer for seven days. Multilevel-regression analyses revealed that for adolescents living in low-income neighborhoods, the association between neighborhood walkability and PA is moderated by perceived barriers and perceived benefits toward PA. Neighborhood walkability was positively associated with PA among adolescents, living in low-income neighborhoods, who perceived many barriers and few benefits, while for adolescents who perceived few barriers and many benefits, the PA level was high, irrespective of neighborhood walkability. For adolescents, living in high-income neighborhoods, none of the psychosocial attributes moderated the association between neighborhood walkability and PA. These findings provide some support for the predicted interactions posited by ecological models. Improving neighborhood walkability might increase PA-levels of adolescents living in low-income neighborhoods, with less positive psychosocial profiles, or in other words; those who are most difficult to reach through PA interventions. However, in order to increase PA in large populations, interventions focusing solely on improving neighborhood walkability may not have the desired effect.

Multilevel predictors of adolescent physical activity: a longitudinal analysis

BACKGROUND

To examine how factors from a social ecologic model predict physical activity (PA) among adolescents using a longitudinal analysis.

METHODS

Participants in this longitudinal study were adolescents (ages 10-16 at baseline) and one parent enrolled in the Transdisciplinary Research on Energetics and Cancer-Identifying Determinants of Eating and Activity (TREC-IDEA) and the Etiology of Childhood Obesity (ECHO). Both studies were designed to assess a socio-ecologic model of adolescent obesity risk. PA was collected using ActiGraph activity monitors at two time points 24 months apart. Other measures included objective height and weight, adolescent and parent questionnaires on multilevel psychological, behavioral and social determinants of PA, and a home PA equipment inventory. Analysis was conducted using SAS, including descriptive characteristics, bivariate and stepped multivariate mixed models, using baseline adjustment. Models were stratified by gender.

RESULTS

There were 578 adolescents with complete data. Results suggest few statistically significant longitudinal associations with physical activity measured as minutes of MVPA or total counts from accelerometers. For boys, greater self-efficacy (B = 0.75, p = 0.01) and baseline MVPA (B = 0.55, p < 0.01) remained significantly associated with MVPA at follow-up. A similar pattern was observed for total counts. For girls, baseline MVPA (B = 0.58, p = 0.01) and barriers (B = -0.32, p = 0.05) significantly predicted MVPA at follow-up in the full model. The full multilevel model explained 30% of the variance in PA among boys and 24% among girls.

CONCLUSIONS

PA change in adolescents is a complex issue that is not easily understood. Our findings suggest early PA habits are the most important predictor of PA levels in adolescence. Intervention may be necessary prior to middle school to maintain PA through adolescence.

FITNESSGRAM® Friday: A Middle School Physical Activity and Fitness Intervention

Texas Senate Bill 530 (2007) mandated fitness assessment as part of the annual K-8 Physical Education (PE) curricula, yet no studies have reported interventions designed to improve and quantify individual student passing rates or individual school performance. Students (Total 2008-2010 N=1484; 729 females, 755 males; mean age = 11.85 y; mean BMI = 22.69 or > 90%-tile, overweight) were evaluated on individual FITNESSGRAM® performances in a cross-sectional analysis of 6th graders comparing baseline scores (year 1) with outcomes of a physical activity intervention in years 2 and 3. Students participated in regular PE classes (including campus wellness center activities) with a once a week focus (FITNESSGRAM® Friday) on improving mile run scores and other assessment scores. Students significantly improved FITNESSGRAM® scores following the PE intervention to levels similar to state reported averages. On average, boys improved their pushups by 32.7%, trunk lift by 17.4% and mile run times by 29.5%. Averages for girls improved by 15.4% for pushups, 6.7% for truck lift, and by 38.6% for the mile run. The percentage of boys in our study achieving all six FITNESSGRAM® tests in the HFZ was 3% at baseline and 22% following intervention. The percentage of girls meeting the criteria for the HFZ on all six FITNESSGRAM® tests was 4.5% at baseline and 20% following intervention. This study provides a potential model for fitness success in other middle school PE interventions, in Texas and the nation.

Active living neighborhoods: is neighborhood walkability a key element for Belgian adolescents?

BACKGROUND

In adult research, neighborhood walkability has been acknowledged as an important construct among the built environmental correlates of physical activity. Research into this association has only recently been extended to adolescents and the current empirical evidence is not consistent. This study investigated whether neighborhood walkability and neighborhood socioeconomic status (SES) are associated with physical activity among Belgian adolescents and whether the association between neighborhood walkability and physical activity is moderated by neighborhood SES and gender.

METHODS

In Ghent (Belgium), 32 neighborhoods were selected based on GIS-based walkability and SES derived from census data. In total, 637 adolescents (aged 13-15 year, 49.6% male) participated in the study. Physical activity was assessed using accelerometers and the Flemish Physical Activity Questionnaire. To analyze the associations between neighborhood walkability, neighborhood SES and individual physical activity, multivariate multi-level regression analyses were conducted.

RESULTS

Only in low-SES neighborhoods, neighborhood walkability was positively associated with accelerometer-based moderate to vigorous physical activity and the average activity level expressed in counts/minute. For active transport to and from school, cycling for transport during leisure time and sport during leisure time no association with neighborhood walkability nor, with neighborhood SES was found. For walking for transport during leisure time a negative association with neighborhood SES was found. Gender did not moderate the associations of neighborhood walkability and SES with adolescent physical activity.

CONCLUSIONS

Neighborhood walkability was related to accelerometer-based physical activity only among adolescent boys and girls living in low-SES neighborhoods. The relation of built environment to adolescent physical activity may depend on the context.

Physical activity, sedentary behavior, and the metabolic syndrome in minority youth

PURPOSE

This study aimed to determine the associations among physical activity, sedentary behavior, and the metabolic syndrome (MetS) in Latino and African American youth using both subjective and objective measures of activity levels.

METHODS

Cross-sectional data from 105 participants from three pediatric obesity studies that share a core set of methods and measures (Latino 74%, female 75%, mean age = 13 ± 3 yr) were used. Measures included moderate-to-vigorous physical activity and sedentary behavior by accelerometry and 3-Day Physical Activity Recall (3DPAR), fat and lean tissue mass by BodPod™, fasting glucose, lipids, blood pressure, and waist circumference. Associations between physical activity, sedentary behavior, and MetS were examined using ANCOVA, Pearson correlations, partial correlations, and logistic regressions with adjustments for age, sex, ethnicity, fat and lean mass, and pubertal Tanner stage.

RESULTS

Accelerometry data showed that greater time engaging in moderate-to-vigorous physical activity was related to lower odds of the MetS (odds ratio = 0.49, 95% confidence interval = 0.25-0.98), independent of sedentary behavior and covariates, and inversely correlated with fasting glucose (r = -0.21, P = 0.03) and systolic blood pressure (r = -0.25, P = 0.01), adjusting for covariates. Data from the 3DPAR showed that higher levels of sedentary behavior were related to higher odds of the MetS (odds ratio = 4.44, 95% confidence interval = 1.33-14.79), independent of moderate-to-vigorous physical activity and covariates, negatively correlated with HDL-cholesterol (r = -0.21, P = 0.04) and positively correlated systolic blood pressure (r = 0.26, P = 0.009), adjusting for covariates.

CONCLUSIONS

Future interventions aiming to improve metabolic health in youth should target both the promotion of physical activity and the reduction of sedentary behavior. Subjective and objective measures should be used in conjunction to better capture activity behaviors.

Progress and future directions on physical activity research among youth

There is strong evidence to support the benefits of regular physical activity for children and adolescents (heretofore referred to as "youth"). Evidence includes improved cardiorespiratory fitness, muscular fitness, bone health, body composition, and cardiovascular and metabolic health biomarkers. Importantly, physical inactivity is a modifiable risk factor for lifestyle-related chronic diseases and conditions and may track through adulthood. Because of the potential benefits and modifiable nature of the behavior, the "2008 Physical Activity Guidelines for Americans" recommends 1 hour or more of daily physical activity for youth. Most of the time should be spent in either moderate-or vigorous-intensity aerobic activities and should also include muscle and bone strengthening activities. The 2010 World Health Organization "Global Recommendations for Physical Activity and Health" supports similar guidelines for youth.