Determinants of adolescent physical activity and inactivity patterns
Determinants of adolescent physical activity and inactivity patterns
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DOI：
10.1542/peds.105.6.e83
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发表时间：
2000-06-01
期刊：
影响因子：
8
通讯作者：
Popkin, BM
中科院分区：
文献类型：
--
作者：
Gordon-Larsen, P;McMurray, RG;Popkin, BM
目标。尽管认识到环境决定因素对身体活动模式的重要影响，但很少有实证研究来评估环境/背景决定因素对身体活动的影响。本文旨在调查美国青少年亚群中运动和不运动模式的环境和社会人口决定因素。我们将环境决定因素定义为物理环境中对参与体育活动的机会施加直接影响的可改变因素。本研究考察了环境和社会人口因素对身体活动和不活动的影响，并暗示这些发现可以指向社会层面的干预策略，以增加青少年的身体活动和减少不活动。研究设计与方法。研究人群包括来自1996年全国青少年健康纵向研究的具有全国代表性的数据，涉及17766名在美国初中和高中就读的美国青少年（包括3933名非西班牙裔黑人，3148名西班牙裔和1337名亚洲人）。通过问卷收集每周不活动（看电视/视频和玩视频/电脑游戏）的小时数和每周进行中度至剧烈体育活动的次数。结果变量为中度至剧烈体力活动和不活动，分为三类（体力活动：0-2次/周，3-4次/周，>5次/周；不活动：0-10小时/周，11-24小时/周，>25小时/周）。运动和不运动的社会人口学和环境相关因素被用作暴露变量和控制变量，包括性别、年龄、城市居住、参加学校体育项目、使用社区娱乐中心、社区报告的严重犯罪事件总数、社会经济地位、种族、在美国居住的世代、母亲/父亲是否在家、怀孕状况、工作状况、在校状况、地区、还有一个月的面试。使用高、低、中体力活动和不活动的逻辑回归模型来调查性别和种族相互作用与环境和社会人口因素的关系，以检验体育教育和娱乐项目以及社会人口因素对体力活动和不活动模式的潜在影响的证据。在非西班牙裔黑人和西班牙裔青少年中，中度至剧烈体育活动的比例较低，不运动的比例较高。这些青少年参加学校体育课程的比例相当低，并且随着年龄的增长而下降。参加日常学校体育课程（调整优势比[AOR]: 2.21；置信区间[CI]: 1.82-2.68）和使用社区娱乐中心（调整优势比：1.75；置信区间[CI]: 1.56-1.96）与参与高水平中度至剧烈体育活动的可能性增加相关。母亲教育程度与高度不活动模式呈负相关；例如，拥有研究生或专业学位的母亲与AOR相关。61 （CI: 0.48 - 0.76）。高家庭收入与增加中度至剧烈体育活动（AOR: 1.43; CI: 1.22-1.67）和减少不运动（AOR: 0.70; CI: 0.59 - 0.82）相关。高社区严重犯罪水平与中高强度体育活动最高类别的可能性降低相关（AOR: 0.77; CI: 0.66 - 0.91）。这些结果表明，可改变的环境因素（如参加学校体育和社区娱乐项目）与青少年的活动模式之间存在重要关联。尽管参加学校体育活动对美国青少年的身体活动模式有显著的影响，但很少有青少年参加学校体育活动；只有21.3%的青少年在学校每周参加一天或更多的体育活动。除了更容易改变的因素外，高犯罪率与每周适度到剧烈体育活动的减少显著相关。影响身体活动的关键可改变因素并不影响不活动。因此，很明显，体力活动和不活动与非常不同的决定因素有关。虽然体力活动与环境因素的关系最为密切，但不活动与社会人口因素的关系最为密切。这里提供的数据证实了研究人员和儿科医生凭直觉知道的事情；然而，这些关系还没有经过实证检验，也没有在任何具有全国代表性的美国学龄儿童调查中进行研究。这些发现表明，不运动的模式不能用这里研究的环境因素来解释，因此，研究人员寻找可能影响不运动的其他环境决定因素显然很重要。国家层面的战略必须包括对学校体育和社区娱乐项目的关注，特别是对于那些没有资源和机会参与体育活动的美国人群。研究测量和探索活动的其他环境决定因素的影响，并确定是否存在不活动的环境决定因素，是未来重要的研究方向。
Objectives. Despite recognition of the important influence of environmental determinants on physical activity patterns, minimal empirical research has been done to assess the impact of environmental/contextual determinants of physical activity. This article aims to investigate environmental and sociodemographic determinants of physical activity and inactivity patterns among subpopulations of US adolescents. We define environmental determinants as modifiable factors in the physical environment that impose a direct influence on the opportunity to engage in physical activity. The present research examines environmental and sociodemographic determinants of physical activity and inactivity with the implication that these findings can point toward societal-level intervention strategies for increasing physical activity and decreasing inactivity among adolescents.Study Design and Methodology. The study population consists of nationally representative data from the 1996 National Longitudinal Study of Adolescent Health on 17 766 US adolescents enrolled in US middle and high schools (including 3933 non-Hispanic blacks, 3148 Hispanics, and 1337 Asians). Hours/week of inactivity (TV/video viewing and video/computer games) and times/week of moderate to vigorous physical activity were collected by questionnaire. Outcome variables were moderate to vigorous physical activity and inactivity, which were broken into categories (physical activity: 0-2 times/week, 3-4 times/week, and >5 times/week; inactivity: 0-10 hours/week, 11-24 hours/week, and >25 hours/week). Sociodemographic and environmental correlates of physical activity and inactivity were used as exposure and control variables and included sex, age, urban residence, participation in school physical education program, use of community recreation center, total reported incidents of serious crime in neighborhood, socioeconomic status, ethnicity, generation of residence in the United States, presence of mother/father in household, pregnancy status, work status, in-school status, region, and month of interview.Logistic regression models of high versus low and medium physical activity and inactivity were used to investigate sex and ethnic interactions in relation to environmental and sociodemographic factors to examine evidence for the potential impact of physical education and recreation programs and sociodemographic factors on physical activity and inactivity patterns.Results. Moderate to vigorous physical activity was lower and inactivity higher for non-Hispanic black and Hispanic adolescents. Participation in school physical education programs was considerably low for these adolescents and decreased with age. Participation in daily school physical education (PE) program classes (adjusted odds ratio [AOR]: 2.21; confidence interval [CI]: 1.82-2.68) and use of a community recreation center (AOR: 1.75; CI: 1.56-1.96) were associated with an increased likelihood of engaging in high level moderate to vigorous physical activity. Maternal education was inversely associated with high inactivity patterns; for example, having a mother with a graduate or professional degree was associated with an AOR of .61 (CI: .48-.76) for high inactivity. High family income was associated with increased moderate to vigorous physical activity (AOR: 1.43; CI: 1.22-1.67) and decreased inactivity (AOR: .70; CI: .59-.82). High neighborhood serious crime level was associated with a decreased likelihood of falling in the highest category of moderate to vigorous physical activity (AOR: .77; CI: .66-.91).Conclusions. These results show important associations between modifiable environmental factors, such as participation in school PE and community recreation programs, with activity patterns of adolescents. Despite the marked and significant impact of participation in school PE programs on physical activity patterns of US adolescents, few adolescents participated in such school PE programs; only 21.3% of all adolescents participated in 1 or more days per week of PE in their schools. In addition to the more readily modifiable factors, high crime level was significantly associated with a decrease in weekly moderate to vigorous physical activity.The key modifiable factors that had an impact on physical activity did not affect inactivity. Thus, it is clear that physical activity and inactivity were associated with very different determinants. Although physical activity was most associated with environmental factors, inactivity was most associated with sociodemographic factors.The data presented here confirm what researchers and pediatricians have known intuitively; however, these relationships have not been tested empirically, nor have they been studied in any nationally representative survey of US school-aged children. These findings show that patterns in inactivity cannot be explained using the environmental factors studied here and, thus, it is clearly important that researchers search for other environmental determinants likely to impact inactivity.National-level strategies must include attention to school PE and community recreation programs, particularly for segments of the US population without access to resources and opportunities that allow participation in physical activity. Research to measure and explore the effects of other environmental determinants of activity and to ascertain whether there are any environmental determinants of inactivity are important future research directions.