This study showed a high prevalence of insufficient physical activity levels and exposure to sedentary behaviors among adolescents.

Abstract

Findings suggest that higher levels of enrollment in PE classes could play a role in the promotion of health-related behaviors among high school students.

Background Structured settings, such as school, childcare, afterschool programs, summer camps, and physical activity/sport programs are crucial to promoting physical activity (PA) opportunities and reducing sedentary (ST) for children and adolescents. However, little is known about how much PA and ST children and adolescents accumulate in structured settings. The aim of this study is to conduct a systematic review and meta-analysis of the absolute amount of time youth spend physically active and sedentary in different structured settings (Prospero number: 42018111804). Methods Observational and experimental/quasi-experimental studies (baseline data only) with full-text available, written in English and published in a peer-reviewed journal, reporting the total amount of objectively measured PA (light, moderate, vigorous, and/or total physical activity) and/or time spent ST during structured settings among youth (3 to 18 years) were eligible. Adjusted meta-analysis was conducted to estimate the pooled mean of time spent in PA and ST, by settings and sex. Results A total of 187 studies (childcare n=60; school n=91; afterschool programs n=14; summer camp n=4; and Physical activity/ sport programs n=18) from 30 countries (47.9% United States), representing 74,870 youth (mean age 8.6 years old) were included. Overall, there was a high variation between studies in outcomes and settings. The meta-analyses revealed, on average, youth spend 221.8 minutes (36.7 min/hour) in ST and 32.1 minutes (5.1 min/hour) in MVPA during childcare hours, and 223.9 minutes (36.7min/hour) in ST and 27.8 min (4.4 min/hour) in MVPA at school. Relatively, youth are engaged in more MVPA in afterschool programs (11.7 min/hour), PA/ sport programs (20.9 min/hour), and summer camps (6.4 min/hour), when compared to childcare and school. Conclusion Total PA accumulated during childcare and MVPA accumulated during schools hours were close to recommendations, despite high proportion of ST. Afterschool programs, summer camp and PA/ sport programs are important settings that can contribute to daily PA and reduced ST. Ensuring all youth have access to these structured settings may be an important step forward for public health.

The results of this study allow us to establish the prevalence of risk behaviors in cluster, which may have important implications for health policies and practices. It is suggested that educational and health actions are tested in schools, and physical education classes can be an important context for intervention.

O objetivo deste estudo foi analisar a associação entre fatores demográficos, sócio-econômicos, escolares e comportamentais e a prevalência de sobrepeso e obesidade em adolescentes. A amostra foi constituída por 4.210 estudantes (14-19 anos) da rede pública estadual em Pernambuco, Brasil, selecionados mediante amostragem por conglomerados em dois estágios. Além das medidas antropométricas, dados pessoais e comportamentais foram coletadas usando o Global School-Based Health Survey. Pontos de corte utilizados para classificação dos casos de sobrepeso e obesidade foram os propostos pelo International Obesity Task Force. A prevalência de sobrepeso e obesidade foi 11,5% (IC95%: 10,7-12,8) e 2,4% (IC95%: 1,9-2,9), respectivamente. Verificou-se maior risco de sobrepeso e obesidade entre rapazes que residiam em áreas urbanas e que não participavam das aulas de educação física. Entre as moças, assistir à televisão três horas ou mais foi fator associado à ocorrência de obesidade. Redução do tempo de televisão e participação nas aulas de educação física podem ser ações efetivas no enfrentamento da epidemia da obesidade.

Purpose The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

Resumo: O objetivo do estudo foi identificar e descrever fatores associados à distribuição em relação aos estágios de mudança de comportamento para prática de atividade física (EMCAF) em adolescentes. Tratase de um estudo transversal desenvolvido mediante análise de dados de 4.207 adolescentes (14-19 anos), estudantes da rede pública estadual de ensino médio do estado de Pernambuco, selecionados em processo amostral por conglomerados em dois estágios. Dados foram coletados mediante uso de questionário previamente testado (GSHS-WHO), adotando-se a seguinte classificação para os EMCAF: (1) manutenção, sujeito fisicamente ativo há mais de 6 meses; (2) ação, sujeito fisicamente ativo há menos de 6 meses; (3) preparação, sujeito não é, mas pretende se tornar fisicamente ativo nos próximos 30 dias; (4) contemplação, sujeito não é, mas pretende se tornar fisicamente ativo nos próximos 6 meses; e (5) pré-contemplação, sujeito não é e não pretende se tornar fisicamente ativo nos próximos 6 meses. Análises de regressão logística ordinal foram empregadas para identificar fatores associados ao EMCAF. Verificou-se que 31,1 e 16,4% dos sujeitos, respectivamente, encontravam-se nos estágios de manutenção e ação. Os rapazes de 14-16 anos e, independente do sexo, os adolescentes que trabalhavam e residiam na região litorânea do estado tinham maiores chances de referir que se encontravam nos estágios de ação e manutenção. Idade para os adolescentes do sexo masculino e trabalho e região de residência para os adolescentes de ambos os sexos foram identificados como fatores associados aos EMCAF. Palavras-chave: Adolescente. Atividade motora. Brasil. Conduta de saúde. Stages of change for physical activity among adolescentsAbstract: The objective of this study was to identify and to describe factors associated with the distribution in relation to the stages of change for physical activity (SCPA) in adolescents. This cross-sectional study was carried out through data analysis from a sample of 4,207 adolescents high-school students (14-19 years old) from the state of Pernambuco (Brazil), selected by a 2-stage cluster sampling process. The data were collected by using a previously tested questionnaire (GSHS-WHO), adopting the following classifications for SCPA: (1) maintenance -subject physically active for more than 6 months; (2) action -subject physically active for less than 6 months; (3) preparation -subject is not active, but would like to become physically active in the next 30 days; (4) contemplation -subject is not active, but would like to become physically active in the next 6 months; and (5) pre-contemplation -subject is not and does not intend to become physically active in the next 6 months. Ordinal logistic regression analyses were used to identify factors associated with SCPA. It was found that 31.1% and 16.4% of subjects, respectively, were in action and maintenance stages. The boys of 14-16 years old and, adolescents who worked and lived in the coastal region of the state, regardless of gender, were more likely to be cla...