Factors associated with meeting the recommendations for physical activity, sedentary behavior, and sleep in adolescents: a cross-sectional study

TL;DR

This study explores how social and environmental factors influence adolescents' adherence to physical activity, sedentary behavior, and sleep guidelines.

Contribution

The study integrates the Social Ecological Model to analyze combined adherence to multiple health behavior recommendations in adolescents.

Findings

Only 1.8% of adolescents met all three health behavior recommendations simultaneously.

Enjoying physical activity and good self-rated sleep quality were strongly associated with meeting combined recommendations.

Having more friends and participating in physical education classes were linked to better adherence to physical activity and sedentary behavior guidelines.

Abstract

To analyze the association between the Social Ecological Model and meeting the physical activity, sedentary behavior, and sleep recommendations in a combined and integrated manner among adolescents.

This is a cross-sectional study conducted in public schools in the Metropolitan Region of Recife, state of Pernambuco, Brazil, with adolescents aged 14 to 17 years. An adapted version of the Global School-based Student Health Survey was used as the instrument. Robust Poisson regressions were performed.

Approximately 1.8% of the 576 adolescents met all three recommendations simultaneously. Enjoying physical activity (prevalence ratio [PR] 11.62; 95% confidence interval [CI] 1.50–89.75) was associated with the combined adherence to the physical activity and sedentary behavior recommendations. Having two or more friends (PR 0.38; 95%CI 0.18–0.76) and participating in one (PR 0.39; 95%CI 0.20–0.78) or two physical education classes per week (PR 0.43; 95%CI 0.20–0.92) were associated with lower probabilities of non-compliance with these recommendations. Self-rated sleep quality as good (PR 2.49; 95%CI 1.09–5.67) was associated with higher prevalence of meeting the combined recommendations for sedentary behavior and sleep. Being male (PR 0.48; 95%CI 0.23–0.97) and participating in one physical education class per week (PR 0.40; 95%CI 0.16– 0.99) were associated with lower prevalence of not meeting the recommendations for sedentary behavior and sleep. Self-reported sleep quality as good (PR 3.11; 95%CI 1.36–7.10) as well as being male (PR 2.10; 95%CI 1.14–3.87) were associated with a higher likelihood of meeting the combined recommendations for physical activity and sleep. Actively commuting to school (PR 0.48; 95%CI 0.27–0.83) was associated with a lower likelihood of not meeting these recommendations.

Intrapersonal, interpersonal, and community factors are associated with adherence to physical activity, sedentary behavior, and sleep recommendations in adolescents.

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