Ellen Haug

The characteristics of the outdoor school environment associated with physical activity

The school is an important setting for physical activity. The purpose of the present study was to examine the association between physical environmental characteristics and participation in daily physical activity during school breaks. Data from 130 schools and 16 471 students (Grades 4–10) in Norway were obtained in 2004 through self-administered questionnaires to principals and students. Multilevel logistic regression models revealed that boys at secondary level with a larger number of outdoor facilities at school had 2.69 times [95% confidence interval (CI) = 1.21–5.98] and girls 2.90 times (95% CI = 1.32–6.37) higher odds of being physically active compared with students in schools with fewer facilities. Boys at secondary level with areas for hopscotch/skipping rope had 2.53 times (95% CI = 1.55–4.13), with a soccer field 1.68 times (95% CI = 1.15–2.45), with playground equipment 1.66 times (95% CI = 1.16–2.37) and with a sledding hill 1.70 times (95% CI = 1.23–2.35) higher odds to be physically active compared with students in schools without these facilities. A sledding hill was also associated with girls’ physical activity participation in secondary school (odds ratio = 1.58, 95% CI = 1.11–2.24). Outdoor facilities in secondary schools are associated with students’ daily physical activity participation during school breaks. Therefore, improving the outdoor environment should be considered in physical activity promotion school programs in secondary schools.

Interrelationships of adolescent physical activity, screen-based sedentary behaviour, and social and psychological health

Objectives:To examine how adolescent physical activity (PA) and screen-based media sedentary behaviours (SBM) relate to psychological and social health and identify cross-national differences in these relationships.Methods:Associations were examined in five regions using two Health Behaviour in School-Aged Children (HBSC) countries from each.Results:Self-reported psychological and social health indices such as self-image, perceived health status, and Life Satisfaction were positively related to PA in all five regions but, with a few exceptions, negatively related to SBM. Negative health indices such as health complaints and tobacco use were negatively related to PA but, with exceptions, positively related to SBM. Significant regional differences were present.Conclusions:Regional differences in correlates of PA and SBM suggest cultural differences in potential effects of PA and SBM and the need to tailor school and public health efforts to the different meanings of PA and SBM for positive and negative health consequences.

Secular trends in moderate-to-vigorous physical activity in 32 countries from 2002 to 2010: a cross-national perspective

BACKGROUND Sufficient levels of moderate to vigorous physical activity (MVPA) give substantial health benefits to adolescents. This article examines trends in physical activity (PA) from 2002 to 2010 across 32 countries from Europe and North America. METHODS Representative samples included 479 674 pupils (49% boys) aged 11 years (n = 156 383), 13 years (n = 163 729) and 15 years (n = 159 562). The trends in meeting the recommendations for PA (at least 60 min daily) were evaluated using logistic regression. RESULTS There was a slight overall increase between 2002 and 2010 (17.0% and 18.6%, respectively). MVPA increased significantly (P ≤ 0.05) among boys in 16 countries. Conversely, nine countries showed a significant decrease. Among girls, 10 countries showed a significant increase (P ≤ 0.05). Eight countries showed a significant decrease. For all countries combined, girls were slightly less likely to show an increase in PA over time. CONCLUSIONS The majority of adolescents do not meet current recommendations of PA. Further investment at national and international levels is therefore necessary to increase PA participation among children and adolescents and reduce the future health burden associated with inactivity.

Local school policies increase physical activity in Norwegian secondary schools

SUMMARY The implementation of school policies to support the adoption of physical activity is one of the main strategies recommended to increase physical activity levels among this age group. However, documentation of the effect of such policies is so far limited. The purpose of this study was to explore policy-related practices to support physical activity in Norwegian secondary schools and their association with recess physical activity. Emphasis was given to examine the association between policies and physical activity, over and beyond, individual level interests and environmental factors and to examine cross-level interaction effects. This cross-sectional study was based on a nationally representative sample of Norwegian secondary schools and grade 8 students who participated in the Health Behaviour in School-aged Children (HBSC) 2005/06 study. The final sample comprised 68 schools and 1347 students. Data were collected through questionnaires. The results showed that schools with a written policy for physical activity and schools offering organized non-curricular physical activity several times a week had a higher proportion of students reporting daily participation in recess physical activity. Multilevel logistic regression analysis demonstrated a cross-level main effect of the policy index after controlling for sex, socio-economic status, individual-level interests and the physical environment. A significant contribution of adding the policy index to the prediction of recess physical activity above that provided by the individual-level interests and the physical environment was demonstrated. The results are encouraging and give scientific support to policy documents recommending the implementation of school policies to increase physical activity.

Promoting Adolescent health through an intervention aimed at improving the quality of their participation in Physical Activity (PAPA): Background to the project and main trial protocol

Funded by the European Commission, the Promoting Adolescent health through an intervention is aimed at improving the quality of their participation in Physical Activity (PAPA) project revolved around the potential of youth sport to promote childrens mental and emotional health and physical activity engagement. A theoretically grounded coach education training programme (i.e. Empowering Coaching™), which was designed to create a sporting environment which was more positive and adaptive for young children, was customised for grassroots soccer, delivered and evaluated via a multi-method cluster RCT across five European countries; namely, England, France, Greece, Norway and Spain. In this article, a key part of the protocol of this large and multi-faceted project is presented. The ethical standards and procedures, characteristics of the population targeted and overall study design, and core self-report questionnaire measures completed by the players are described. Information is provided as well on the translation principles and procedures and data-collection procedures adopted in the PAPA project.

Trends in overweight prevalence among 11-, 13- and 15-year-olds in 25 countries in Europe, Canada and USA from 2002 to 2010

BACKGROUND The purpose of this study was to assess recent changes in the prevalence of overweight (including obesity) among 11-, 13- and 15-year-olds in 33 countries from 2002 to 2010. METHODS Data from 25 countries from three consecutive survey cycles (2002, 2006 and 2010) that had at least 80% response rate for self-reported height, weight and age were analysed using logistic regression analysis. RESULTS Overweight prevalence increased among boys in 13 countries and among girls in 12 countries; in 10 countries, predominantly in Eastern Europe, an increase was observed for both boys and girls. Stabilization in overweight rates was noted in the remaining countries; none of the countries exhibited a decrease over the 8-year period examined. In the majority of countries (20/25) there were no age differences in trends in overweight prevalence. CONCLUSION In over half of the countries examined overweight prevalence did not change during 2002-2010. However, increasing overweight prevalence was noted in many Eastern European countries over this time period. Overweight prevalence remained high in several countries in Europe and North America. These patterns call for continued research in youth overweight and highlight the need to understand cross-national differences by examining macro-level indicators. Such research should feed into developing sound translations and practices to prevent and reduce overweight in youth.

Comparing self-reported leisure-time physical activity, subjective health, and life satisfaction among youth soccer players and adolescents in a reference sample

The aim of the study was to examine to what extent young people who play organised soccer rate their leisure-time moderate-to-vigorous physical activity, life satisfaction, and health more positively and higher than a same-aged population-based reference group (including some adolescents who also played organised soccer). Data from two samples of five countries (England, France, Greece, Norway, and Spain) were included: a sample of soccer players aged 10-14 years who participated in the Promoting Adolescent Physical Activity project [Duda, J.L., Quested, E., Haug, E., Samdal, O., Wold, B., Balaguer, I., …  Cruz, J. (2013). Promoting Adolescent health through an intervention aimed at improving the quality of their participation in Physical Activity (‘PAPA’): background to the project and main trial protocol. International Journal of Sport and Exercise Psychology] and a nationally representative reference sample of 11- and 13-year olds from the Health Behaviour in School-aged Children study. Results from multivariate logistic regression analysis showed that the participants in the soccer sample, in particular girls, reported a higher level of moderate-to-vigorous leisure-time physical activity than those in the reference sample. They also rated their life satisfaction and subjective health more favourably than the reference sample. The associations did not differ according to age or socio-economic status. The results suggest that playing soccer is a positive activity for youth and seems to be a very potent way of increasing regular moderate-to-vigorous physical activity among girls. Thus, efforts aimed at increasing participation in organised youth soccer may potentially be beneficial to young peoples psychosocial health and hold the potential to increase physical activity, particularly among girls.

Psychometric properties of the five-item version of the Mindful Awareness Attention Scale (MAAS) in Norwegian adolescents:

Objectives: The aim of the present study was to examine the factor structure, model-based reliability, measurement invariance and concurrent validity of the five-item version of the Mindfulness Attention Awareness Scale (MAAS) in Norwegian adolescents. Methods: An initial pilot study was carried out using a sample of 77 fifteen year olds. For the main analyses, a sample of 2140 Norwegian adolescents was used who participated in the cross-sectional Health Behaviour in School-Aged Children (HBSC) study. All participants were asked to complete a questionnaire. Results: Confirmatory factor analyses found support for the one-factor structure of the five-item version of the MAAS. Acceptable model fit was found in both the pilot sample (χ2=6.48, df=5, p=0.26; root mean square error of approximation [RMSEA]=0.06; comparative fit index [CFI]=0.99; standardised root mean square residual [SRMR]=0.03) and the HBSC sample (χ2=27.1, df=4, p<0.001; RMSEA=0.05; CFI=0.99; SRMR=0.01). The model-based reliability of the scale was good (ω=0.84 and ω=0.81, respectively). Scalar measurement invariance was established for sex, age and material affluence. Finally, the five-item MAAS displayed concurrent validity through moderate negative associations with health complaints (r=−0.44; p<0.001) and school stress (b=−0.44, p<0.001), and a positive moderate correlation with life satisfaction (r=0.26; p<0.001). Conclusions: The five-item version of the MAAS is an adequate measure of mindfulness in Norwegian adolescents. Due to the brief nature of the scale, it can easily be included in epidemiological and clinical studies with an interest for trait mindfulness. The five-item MAAS may therefore have great potential to facilitate more knowledge about the role of mindfulness in adolescent health.

Are associations between electronic media use and BMI different across levels of physical activity

BackgroundThe use of electronic media has been found to be a risk factor for higher BMI and for being overweight. Physical activity has been found to be associated with lower BMI and lower risk for being overweight. Little is known about whether the associations between physical activity and electronic media use are additive or interactive in predicting BMI and risk for overweight among adolescents.MethodsThe data used in this study stem from the 2009/2010 survey of “Health Behaviour in School-aged Children (HBSC) study: A WHO Cross-National Survey. The sample consisted of 107184 13 and 15 year students from 30 different countries. Multilevel regression models were used to produce the presented estimates.ResultsOverall, 18% of boys and 11% of girls were classified as overweight. EM use was found to be associated with increased BMI z-scores and odds for overweight among both boys and girls who did not comply with physical activity guidelines. Among physically active adolescents, EM was found to be significantly associated with BMI or odds for overweight among girls, but not among boys.ConclusionWhile the usage of EM appear to be inconsequential for BMI and the risk of overweight among physically active boys, we find evidence indicating that EM use is associated with BMI and risk for overweight among girls, including those who report complying with MVPA guidelines.