Influencing Factors Of Physical Activity Among Adolescent And Middle-age Adults In Shanghai

Objective To explore the influencing factors of physical activity (PA) among the adolescent and middle-aged adults in Shanghai, and focus analysis on how neighborhood environment and social support affect the physical activity behavior of the residents in Shanghai, and provide the basis for making interventions of physical activity suitable for Chinese urban residents in the field of public health.Materials and methods Research was conducted as part of a cross-sectional study, and two typical junior high schools in Shanghai were conveniently selected as case studies:one in the downtown area and another in the suburb. The grade-2students in junior high school and their parents were recruited as subjects. Objective and subjective methods were used in the study, and participants’ physical activity was measured using questionnaires and accelerometers, questionnaires were used to measure participants’ perception of neighborhood environment and social support. The survey covered information on demographics, physical activity, neighborhood environment and social support. Chi-square test, Mann-Whitney U test, Spearman correlation analysis, multi-linear regression and Logistic regression were conducted for data analysis.Results(1) The age of the surveyed students and parents was separately13-15and34-45years old, respectively representing the age group of adolescent and middle-aged adults.(2) No significant correlation was found between total physical activity measured by questionnaire survey and steps/Moderate-Vigorous Physical Activity (MVPA) measured by accelerometer survey among students (P>0.05). Total Physical activity, as captured by the International Physical Activity Questionnaire (IPAQ)-Long Form survey, was positively correlated with steps (r=0.454, P<0.001) and MVPA (r=0.232, P<0.001) measured by accelerometer survey among parents. Sum of walking and moderate-intensity physical activity, as captured by the IPAQ survey, was positively correlated with moderate-level of activity (r=0.221, P<0.01) measured by accelerometer survey among parents.(3) Students in downtown did more walking in school day, exercising in weekend and steps but less bicycling and vigorous-level of activity than the counterparts in suburb (P<0.05). Parents in downtown did more transportation PA, leisure-time PA and walking than the ones in suburb (P<0.05). Boys in suburb did more exercise, steps and MVPA than girls in suburb (P<0.05). Women did more domestic-related PA, moderate-intensity PA, total PA, steps, MVPA, moderate-level and vigorous-level of activity than men (P<0.05). Family income was negatively associated with walking but positively with vigorous-level among parents (P<0.05). Education background was negatively associated with occupational PA and moderate-intensity PA (P<0.05).(4) More walking in school day was associated with perceived enough width of sidewalks in the neighborhood around home among students (OR=9.1, P<0.05). More total PA was associated with traffic volume influencing bicycling in the neighborhood around home among students (OR=2.9, P<0.05). Perceived exercise time in school day was positively associated with accessibility to sports facilities and multiple routes to destinations in the neighborhood around home among students in suburb (P<0.05). MVPA was positively associated with accessibility to sports facilities in the neighborhood around home among students in suburb (β=5.290, P<0.05). Multiple routes to destinations was positively associated with MVPA and steps among students in downtown (P<0.05).(5) In the unadjusted model of middle-aged adults, residential density was negatively associated with walking and leisure-time PA but positively with steps, MVPA and moderate-level of activity among parents (P<0.05). Land use mix-diversity was negatively associated with leisure-time PA, moderate-intensity PA and total PA but positively with steps among parents(P<0.05). Land use mix-access was positively associated with vigorous-level of activity among parents (P<0.05). Walking/Cycling facilities was positively associated with walking and total PA among parents (P<0.05). Traffic safety was negatively associated with walking, MVPA and moderate-level of activity among parents (P<0.05). However, no significant association was found between PA among parents and street connectivity, aesthetics, crime safety (P>0.05). In the adjusted model, only two environmental variables (residential density and land use mix-diversity) were associated with PA among parents.(6) No significant association was found between support from family members and PA behaviors among students (P>0.05), but support from friends was positively associated with cycling in weekend among students in downtown and suburb, exercise in weekend among students in suburb, steps and MVPA among students in downtown (P<0.05). For the parents, no significant association was found between support from friends and PA behaviors (P>0.05), but support from family members was positively associated with walking, transportation PA, leisure-time PA, total PA and MVPA (P<0.05).Conclusion The influencing environmental and social support variables of each physical activity behaviors among adolescent and middle-aged adults were different. Residential density and land use mix-diversity might be the most important neighborhood environmental variables influencing PA among middle-aged adults. Support from friends facilitated the PA behaviors among adolescent while support from family members promoted the PA behaviors among middle-aged adults. Demographic characteristics mediated the association between PA behaviors and neighborhood environment, social support among adolescent and middle-aged adults. The results provided the basis for making specific PA interventions for different areas and populations.