Factors associated with out-of-school physical activity among Chinese children and adolescents: A stratified cross-sectional study

Xin Ge; Erliang Zhang; Yujie Liu; Huilun Li; Fan Hu; Jianchang Chen; YiRan Wang; Yong Cai; Mi Xiang

doi:10.1016/j.ypmed.2024.107985

Factors associated with out-of-school physical activity among Chinese children and adolescents: A stratified cross-sectional study

Prev Med. 2024 May 3:184:107985. doi: 10.1016/j.ypmed.2024.107985. Online ahead of print.

Authors

Xin Ge¹, Erliang Zhang², Yujie Liu², Huilun Li³, Fan Hu², Jianchang Chen⁴, YiRan Wang⁵, Yong Cai⁶, Mi Xiang⁷

Affiliations

¹ Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; Public Health department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Xianxia Road, No.1111, Shanghai 200336, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227. South Chongqing Road, Shanghai 200025, China.
² School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227. South Chongqing Road, Shanghai 200025, China.
³ Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227. South Chongqing Road, Shanghai 200025, China.
⁴ Shanghai Educational Center Of Science & Art, Shanghai 200051, China.
⁵ Shanghai University, 99 Shangda Road Baoshan District, Shanghai 200444, China.
⁶ Public Health department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Xianxia Road, No.1111, Shanghai 200336, China. Electronic address: Caiyong202028@hotmail.com.
⁷ Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya 572022, China; Public Health department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Xianxia Road, No.1111, Shanghai 200336, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, No.227. South Chongqing Road, Shanghai 200025, China. Electronic address: xiang-sjtu@hotmail.com.

PMID: 38705485
DOI: 10.1016/j.ypmed.2024.107985

Abstract

Objective: This observational study examined the factors associated with the physical activity (PA) of children and adolescents outside of school within the framework of Problem Behavior Theory (PBT).

Methods: This cross-sectional study obtained data from 6528 children and adolescents aged 6-16 years recruited from ten schools in Shanghai, China. The questionnaire measured out-of-school PA and PBT-based correlates. A series of multiple linear regressions were used to explore the factors influencing children and adolescents' out-of-school PA separately. Structural equation modeling (SEM) was used to explore the association between the three systems of PBT and out-of-school PA.

Results: Higher intrinsic motivation is positively associated with increased PA for children (b = 1.038, 95%CI: 0.897-1.180) and adolescents (b = 1.207, 95%CI: 0.890-1.524). Greater frequency of parental involvement in PA correlates with elevated PA for both children (b = 2.859, 95%CI: 2.147-3.572) and adolescents (b = 2.147, 95%CI: 0.311-3.983). In children, increased use of community exercise areas or facilities (b = 1.705, 95%CI: 0.234-3.176) and higher recreational screen time (b = 9.732, 95%CI: 5.614-13.850) are associated with higher PA. The SEM showed that factors of the personality system had a significant direct effect on out-of-school PA among children and adolescents, and factors of the behavior system also had a significant effect on children.

Conclusions: Our findings suggest that the personality system, particularly intrinsic motivation, is important in promoting out-of-school PA in children and adolescents. For children, modifiable health behaviors in the behavior system can similarly influence PA.

Keywords: Adolescents; Children; Heath behaviors; Outside school; Physical activity; Problem behavior theory.