Jo Inchley

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.

Evaluating the health promoting school: a case study approach

The health promoting school concept is now a well‐established framework for the development of health promotion initiatives in schools. Increasingly, attention has focused on the evaluation of school‐based health promotion and debate continues over appropriate evaluation designs for the school setting. The authors argue that the case study design provides a useful approach because of its ability to explore the real‐life complexities of social contexts using a combination of quantitative and qualitative methods, with a strong emphasis on process as well as outcome measures. The current ENHPS project in Scotland uses a multiple‐case study design to evaluate healthy eating initiatives in four schools, based on the principles of the health promoting school. Provides a description of the project and highlights the advantages of case study methodology in addressing key issues around effectiveness of school‐based health promotion based on the health promoting school concept.

Socio-environmental influences on physical activity among young people: a qualitative study

This multi-methods qualitative study aimed to identify environmental factors that influence physical activity participation among young people in Edinburgh, Scotland. School pupils (aged 11-13 years) took part using photography, computer blogs, maps and focus group discussions (FGDs). Eleven computer sessions (n = 131) and 14 FGDs (n = 63) took place. Factors influencing physical activity behaviour included proximity and access to local facilities, family and peers and the school physical activity environment. A variety of facilitators and barriers to participation were also reported. Most notable was the importance of cost and value for money when choosing physical activities which, although more evident among pupils attending schools in areas of low socio-economic status (SES), was relevant across all SES groups. Reporting easy access to sports facilities was more common among pupils attending schools from high/medium SES. Use of greenspace for physical activity was reported among pupils from all schools, but was more common among those from low SES schools. Pupils were, in general, satisfied with the facilities available at school, but felt time for physical education could be increased. Findings may help inform interventions, aimed at promoting physical activity at local level.

Subjective health and mental well‐being of adolescents and the health promoting school: A cross‐sectional multilevel analysis

Purpose – The aim of this paper is to examine the impact of the health promoting school (HPS) on adolescent well‐being.Design/methodology/approach – Data from the 2006 Health Behaviour in School‐aged Children: WHO‐collaborative Study in Scotland were analysed using multilevel linear regression analyses for outcome measures: happiness, confidence, life satisfaction, feeling left out, helplessness, multiple health complaints (MHC) and self‐rated health.Findings – Particularly high proportions of both boys and girls reported high life satisfaction and no MHC. For the majority of outcomes, mean proportions of young people reporting positive well‐being were greater for schools that had or were working towards HPS status compared with those that did not. The odds of young people in a HPS never feeling left out were significantly greater than those in a school with no HPS status (OR=1.54, with 95 per cent CI (1.03, 2.29) for boys, OR=1.60 (1.03, 2.50) for girls). Similarly, among girls, the odds of never feeling...

Walking behaviours among adolescent girls in Scotland: a pilot study

Purpose – The wide ranging physical and mental health benefits of physical activity during adolescence are well established and walking has been identified as one of only two forms of physical activity not to show a significant decrease in participation levels across the primary/secondary years. The aim of this paper is to explore the broader context in which adolescent girls walk and to investigate their walking behaviours, experiences and attitudes.Design/methodology/approach – Focus groups discussions and a mapping exercise were carried out with 27 adolescent girls from one urban and one rural school in Scotland.Findings – Key themes identified focussed on current walking behaviours (e.g. type/purpose), physical environmental (e.g. safety, aesthetics), social environmental (e.g. family/friends) and individual (e.g. motivations, beliefs) factors. Walking was a popular activity among urban and rural girls, although areas in which walking took place, and reasons for walking could differ between geographic...

Phases of health promotion implementation into the Scottish school system

Schools have been identified as ideal settings for health promotion (HP) among children, adolescents and school staff. Most European countries have established strategies to implement HP into their school system, however, little is known about these national strategies and how effective they have been. School HP implementation concerns processes of adoption, adaptation and operation of a complex intervention into a complex setting. This study analyses the processes that have led to school HP implementation in Scotland from the 1980s until now to identify key factors which facilitated and supported effective implementation. In the tradition of case-study research, 14 interviews with representatives of national and local organizations involved in school health, as well as with school staff were conducted. Furthermore, policy documents, reports and guidelines were collected. The data were analysed following a Grounded Theory approach. Four phases of school HP implementation into the Scottish school system were identified: (i) getting started (1980s-1998), (ii) political will and strategic vision (1999-2001), (iii) national leadership (2002-2008), and (iv) integration and embedding into education system (2008-ongoing). Throughout the phases political will and committed actors, the strategy/tradition to give power to the local authorities and individual schools, and the establishment of partnerships and ownership have supported implementation. Scotland is an interesting case giving important insights into the ways and possibilities of negotiating an interdisciplinary and cross-sectoral theme such as HP in schools. Further research concerning different political systems and national implementation processes is important to widen the understanding of national implementation strategies of school HP.

Health‐promoting school indicators: schematic models from students

Purpose – The purpose of this paper is to outline a three‐stage process for engaging with students to develop school level indicators of health; in sequential class groups students first generated, then categorised indicators and finally developed schematic representations of their analyses. There is a political and practical need to develop appropriate indicators for health‐promoting schools. As key stakeholders in education, students have the right to be fully engaged in this process.Design/methodology/approach – The sample in this paper comprised 164 students aged 16‐17 years in three medium‐sized Dublin schools. In the first classroom, students answered the question “If you moved to a new school, what would it need to have to be a healthy place?” on individual flashcards. In the second classroom students classified the flashcards into groups using a variation of the card game “snap”. In the third classroom, students discussed the relationships between the developed categories and determined how the ca...

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.

Self-reported weight and predictors of missing responses in youth

OBJECTIVE The aims of the present manuscript are to analyse self-reported data on weight, including the missing data, from the 2014 Scottish Health Behaviour in School-Aged Children (HBSC) Study, and to investigate whether behavioural factors related with overweight and obesity, namely dietary habits, physical activity and sedentary behaviour, are associated with weight non-response. RESEARCH METHODS & PROCEDURES 10839 11-, 13- and 15-year-olds participated in the cross-national 2014 Scottish HBSC Study. Weight missing data was evaluated using Littles Missing Completely at Random (MCAR) test. Afterwards, a fitted multivariate logistic regression model was used to determine all possible multivariate associations between weight response and each of the behavioural factors related with obesity. RESULTS 58.9% of self-reported weight was missing, not at random (MCAR p < 0.001). Weight was self-reported less frequently by girls (19.2%) than by boys (21.9%). Participants who reported low physical activity (OR 1.2, p < 0.001), low vegetable consumption (OR 1.24, p < 0.001) and high computer gaming on weekdays (OR 1.18, p = 0.003) were more likely to not report their weight. CONCLUSIONS There are groups of young people in Scotland who are less likely to report their weight. Their weight status may be of the greatest concern because of their poorer health profile, based on key behaviours associated with their non-response. Furthermore, knowing the value of a healthy weight and reinforcing healthy lifestyle messages may help raise youth awareness of how diet, physical activity and sedentary behaviours can influence weight.