A multilevel examination of gender differences in the association between features of the school environment and physical activity among a sample of grades 9 to 12 students in Ontario, Canada

<p>Abstract</p> <p>Background</p> <p>Creating school environments that support student physical activity (PA) is a key recommendation of policy-makers to increase youth PA. Given males are more active than females at all ages, it has been suggested that investigating gender differences in the features of the environment that associate with PA may help to inform gender-focused PA interventions and reduce the gender disparity in PA. The purpose of this cross-sectional study was to explore gender differences in the association between factors of the school environment and students' time spent in PA.</p> <p>Methods</p> <p>Among a sample of 10781 female and 10973 male students in grades 9 to 12 from 76 secondary schools in Ontario, Canada, student- and school-level survey PA data were collected and supplemented with GIS-derived measures of the built environment within 1-km buffers of the 76 schools.</p> <p>Results</p> <p>Findings from the present study revealed significant differences in the time male and female students spent in PA as well as in some of the school- and student-level factors associated with PA. Results of the gender-specific multilevel analyses indicate schools should consider providing an alternate room for PA, especially for providing flexibility activities directed at female students. Schools should also consider offering daily physical education programming to male students in senior grades and providing PA promotion initiatives targeting obese male students.</p> <p>Conclusions</p> <p>Although most variation in male and female students' time spent in PA lies between students within schools, there is sufficient between-school variation to be of interest to practitioners and policy-makers. More research investigating gender differentials in environment factors associated with youth PA are warranted.</p

The associations between sedentary behaviour and mental health among adolescents:A systematic review

Background: With technological developments and modernised sedentary lifestyles has come an increase in diseases associated with inactivity such as obesity and other non-communicable diseases. Emerging evidence suggests that time spent sedentary may also interact with mental health. This systematic review examined the associations between sedentary behaviour and mental health problems among adolescents. Methods: This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and applied a quality assessment tool for quantitative studies to identity best available evidence. Following stringent search strategy of the databases; Cumulative Index to Nursing and Allied Health Literature, Global Health, Health Source: Nursing and Academic Edition, MEDLINE, PsychARTICLES and PsycINFO, we identified 32 articles eligible for review. Results: All studies reported leisure screen time among adolescents, and two thirds of identified studies examined depressive symptomatology. Other mental health measures were; anxiety symptoms, self-esteem, suicide ideation, loneliness, stress, and psychological distress. Strong consistent evidence was found for the relationship between both depressive symptomatology and psychological distress, and time spent using screens for leisure. Moderate evidence supported the relationship between low self-esteem and screen use. Poorer mental health status was found among adolescents using screen time more than 2-3 h per day, and gender differences exist. Essential information was missing for quality of evidence including heterogeneity in mental health and screen time-based measures, and self-report data collection methods. Conclusions: The findings are of particular significance given the global public health concern of lifestyle-attributed diseases and the possibility for novel approaches to mental health. Future research should examine the psychological impact of reducing time spent using screens for leisure among adolescents, whilst accounting for possible confounding factors such as physical activity and dietary behaviours. It is critical that the reciprocal relationship between lifestyle behaviours and mental health is represented in both the psychiatric and public health forum

Healthy Universities: a guiding framework for universities to examine the distinctive health needs of its own student population.

The underlying principle of settings for health is that investments in health are made within social systems in which health is not necessarily the main remit. In order to understand the health needs of its own community, a growing movement of Healthy Universities is interested in applying the approach within the higher education sector. This study examined the student health behaviours of one university so that future initiatives can be tailored to its own student population.Quantitative data were gathered from 3,683 students studying at a UK urban university. A 60-question online student questionnaire focusing on seven key topic areas was used to gather data and simple descriptive statistics are used to present key findings.The study has identified a need for considering alternative ways of engaging students with appropriate health services throughout the academic year. A focus for university initiatives around healthy eating options, how to cook healthy food and the importance of keeping hydrated is highlighted as a common need. Risky behaviour involving alcohol, drug and substance use and sexual activity suggests a strong argument for not separating university sexual health and alcohol interventions.Underpinned by the Healthy Universities settings concept, this study examined the health and wellbeing behaviours of one university's own student population. It highlights behaviours within the university that are similar to national averages, and some that are not. This understanding can inform the planning of future health promoting university initiatives to meet the distinctive needs of its own students

Theory and practice of social norms interventions: eight common pitfalls.

BACKGROUND: Recently, Global Health practitioners, scholars, and donors have expressed increased interest in "changing social norms" as a strategy to promote health and well-being in low and mid-income countries (LMIC). Despite this burgeoning interest, the ability of practitioners to use social norm theory to inform health interventions varies widely. MAIN BODY: Here, we identify eight pitfalls that practitioners must avoid as they plan to integrate a social norms perspective in their interventions, as well as eight learnings. These learnings are: 1) Social norms and attitudes are different; 2) Social norms and attitudes can coincide; 3) Protective norms can offer important resources for achieving effective social improvement in people's health-related practices; 4) Harmful practices are sustained by a matrix of factors that need to be understood in their interactions; 5) The prevalence of a norm is not necessarily a sign of its strength; 6) Social norms can exert both direct and indirect influence; 7) Publicising the prevalence of a harmful practice can make things worse; 8) People-led social norm change is both the right and the smart thing to do. CONCLUSIONS: As the understanding of how norms evolve in LMIC advances, practitioners will develop greater understanding of what works to help people lead change in harmful norms within their contexts. Awareness of these pitfalls has helped several of them increase the effectiveness of their interventions addressing social norms in the field. We are confident that others will benefit from these reflections as well

Profils de multiples comportements à risque pour la santé des étudiants universitaires et leurs liens avec la santé mentale : utilisation de l’analyse des classes latentes

Introduction : Les campus universitaires et collégiaux sont sans doute les derniers milieux au sein desquels il est possible d’aborder de façon globale la question de la santé d’une grande proportion de la population de jeunes adultes. Il est important que les promoteurs de la santé saisissent en quoi consistent les difficultés collectives auxquelles font face les étudiants et qu’ils comprennent mieux les modèles plus larges de comportements liés au mode de vie qui se manifestent au cours de cette période de la vie. L’objectif de notre étude a été de déterminer des catégories de comportements à risque pour la santé modifiables et d’étudier la relation entre ces catégories et divers paramètres relevant de la santé mentale au sein d’un vaste échantillon d’étudiants universitaires canadiens. Méthodologie : Des étudiants de premier cycle (n = 837, âge moyen = 21 ans) de l’Université de Toronto ont répondu à l’enquête National College Health Assessment (NCHA) (évaluation nationale de la santé dans les collèges) qui comprend environ 300 éléments, dont des évaluations de l’état de santé, de la santé mentale et des comportements à risque pour la santé des étudiants. Nous avons réalisé une analyse des classes latentes pour relever des profils en fonction de huit comportements à risque pour la santé connus (consommation de marijuana, consommation d'autres drogues illégales, rapports sexuels à risque, tabagisme, excès occasionnel d’alcool, mauvaise alimentation, inactivité physique, manque de sommeil). Résultats : Nous avons obtenu un modèle à trois catégories axé sur les profils de comportement des étudiants : étudiants « typiques », « à risque élevé » et « relativement en bonne santé ». Nos résultats ont par ailleurs montré que les étudiants à risque élevé ont déclaré souffrir d’un niveau de stress considérablement plus élevé que celui des étudiants typiques (χ2 [1671] = 7,26; p < 0,01). Conclusion : Les étudiants les plus susceptibles d’adopter de multiples comportements à risque pour la santé ont fait état d’une moins bonne santé mentale, particulièrement en ce qui concerne le stress. Bien que l’on doive interpréter ces conclusions avec prudence en raison du taux de réponse de 28 %, celles-ci suggèrent néanmoins que l’on pourrait envisager des interventions ciblées auprès de groupes d’étudiants ayant des profils similaires de multiples comportements à risque pour la santé

Patterns of multiple health risk-behaviours in university students and their association with mental health: application of latent class analysis

University and college campuses may be the last setting where it is possible to comprehensively address the health of a large proportion of the young adult population. It is important that health promoters understand the collective challenges students are facing, and to better understand the broader lifestyle behavioural patterning evident during this life stage. The purpose of this study was to examine the clustering of modifiable health-risk behaviours and to explore the relationship between these identified clusters and mental health outcomes among a large Canadian university sample. Methods: Undergraduate students (n = 837; mean age = 21 years) from the University of Toronto completed the National College Health Assessment survey. The survey consists of approximately 300 items, including assessments of student health status, mental health and health-risk behaviours. Latent class analysis was used to identify patterning based on eight salient health-risk behaviours (marijuana use, other illicit drug use, risky sex, smoking, binge drinking, poor diet, physical inactivity, and insufficient sleep). Results: A three-class model based on student behavioural patterns emerged: "typical," "high-risk" and "moderately healthy." Results also found high-risk students reporting significantly higher levels of stress than typical students (χ2(1671) = 7.26, p < .01). Conclusion: Students with the highest likelihood of engaging in multiple health-risk behaviours reported poorer mental health, particularly as it relates to stress. Although these findings should be interpreted with caution due to the 28% response rate, they do suggest that interventions targeting specific student groups with similar patterning of multiple health-risk behaviours may be needed

Physical Activity and the Home Environment of Pre-School-Aged Children in Urban Bangladesh

Physical activity (PA) is a key determinant of health and development, yet few studies have examined PA levels and risk factors for low PA among young children in low- and middle-income countries. This study aimed to describe the PA and sedentary (SED) behavior levels of preschool-aged children in Dhaka, Bangladesh, and to estimate the associations between potential risk factors in the home built environment and moderate to vigorous PA (MVPA). In a sample of preschool-aged children (n = 65) in Dhaka, PA and SED behavior were measured for 7 days using ActiGraph GT3X-BT accelerometers. Characteristics of the home built environment, socioeconomic factors, and anthropometry were also measured. Linear mixed-effects models were used to estimate multivariable-adjusted associations between characteristics of the home environment and MVPA. Preschool-aged children spent a mean (±standard deviation) 421 ± 48 and 82 ± 23 min per day sedentary and in MVPA, respectively. There were no statistically significant associations between factors in the home built environment (indoor area, presence of an open stairwell, and presence of gross motor activity facilitating items) and MVPA. These findings suggest that the studied characteristics of the home built environment may not significantly influence the MVPA observed among preschool-aged children in Dhaka. Future research should focus on other structural and behavioral factors that facilitate PA among young children in dense urban settings