Physical Activity And Its Influencing Factors Among Children And Adolescents Of Provincial Capitals Of China

ObjectiveRecent decades have experienced a decline in physical activity(PA)owning to the change of living environment and personal behavior habits among children and adolescents in China.Several studies have reported the affecting factors of PA by analyzing the compliance rate of moderate-to-vigorous physical activity(MVPA).However,the MVPA compliance rate alone maybe not enough to reflect PA.It is more scientific to comprehensively evaluate all the PA characteristics to find out affecting factors of PA.This study aims to explore the influence of demographic and personal behavior,socio-economic and natural environment on PA,so as to provide certain theoretical basis for the improvement of PA of Chinese children and adolescents in the future.MethodsAccording to the six division of Chinese administrative regions(East China,South China,North China,Central China,Southwest and Northwest),seven provincial capital cities(Shanghai,Urumqi,Taiyuan,Changsha,Kunming,Guangzhou,Chengdu)were selected in 2018 for the present study.A total of 4,269 children and adolescents aged 7~18 years old were recruited adopting a stratified cluster random sampling method.“Questionnaire for Physical Activity Level Evaluation among Chinese Children and Adolescents aged 7 to 18 years old” were conducted to obtain PA and its influencing factors related information.Firstly,K-S normality test was used to check the normality of PA variables.Secondly,calculate the quartile of PA time variable,Values are presented as median(25th,75 th percentiles),and calculate the percentage of MVPA deficiency.Kruskal-Wallis H test,Wilcoxon rank-sum test and chi-square test were used to analyze the PA situation for children and adolescents in seven provincial capital cities,and the differences in PA status between different demographic groups and groups of individual behavior,social economy and natural environment factors were comparedcompare the PA levels with different demographic.Finally,we conducted binary logistic regression model to analyze the main influencing factors on the MVPA compliance of children and adolescents in provincial capitals.The level of statistical significance was set at 0.05.All analyses were conducted using SPSS version 25.0(IBM,Armonk,NY,USA).Result(1)The situation of PA for children and adolescents in provincial capitals of ChinaThe median of Total physical activity(TPA),light-intensity activity(LPA),moderate-intensity activity(MPA),Vigorous-intensity Activities(VPA)and MVPA were 92.9 min/d,24.3 min/d,41.4 min/d,7.1 min/d and 55.7 min/d,respectively,and there were sinificant differences among regions.Shanghai and Changsha had the lowest MVPA,which were 41.4 min/d and 50.7 min/d,(P<0.05).The MVPA deficiency rate of children and adolescents in the seven provincial capitals was 53.8%,with the highest rates in Shanghai(65.9%)and Changsha(60.0%)(P<0.001).In addition,PA such as walking,broadcast gymnastics,outdoor chasing,running,climbing stairs and housework accounted for 55.3% of total PA time,with "physical exercise" accounting for 44.7%.(2)Demographic and individual behavioral factors,socio-economic factors and natural environment factors were grouped to compare PA statusDemographic and personal behavior factors: The MVPA deficiency rate was 50.8% for boys and 57.1% for girls(P<0.001).The MVPA deficiency rates for "7~9 years old","10~12 years old","13~15 years old" and "16~18 years old" students were 57.6%,43.6%,50.8% and 63.0%,respectively(P<0.001).The MVPA deficiency rates were 61.5% for students with sleep time ?6h and 52.6% for students with sleep time > 6h groups,which showed statistical significance(P<0.001).The physical exercise time were 37.86min/d and 31.43min/d for boys and girls,repectively(P<0.001).The physical exercise time were 35.71min/d for students with sleep time >6h,which were significantly higher than that ?6h groups(P<0.001).Socio-economic factors: The insufficient MVPA rate of children and adolescents with "low socioeconomics status(SES),middle SES and high SES were 48.9%,57.5% and 54.8%,respectively(P<0.001).The MVPA deficiency rate in urban and suburban areas were 55.8% and 50.8%,respectively(P=0.001).In addition,the time for traffic activities was 40min/d for the low SES group,which was significantly higher than the middle SES group(27.14min/d)and the high SES group(27.14min/d).The time for traffic activities was 34.29min/d in suburban areas,which was significantly higher than that in urban areas(27.14min/d)(P<0.001).Natural environmental factors: The MVPA deficiency rate in the "semi-arid","wet" and "rainy" regions were 47.6%,53.3% and 62.8%,respectively(P<0.001).The MVPA deficiency rates in the comfortable and hot regions were 51.6% and 65.9%,respectively(P<0.001).In addition,the time for traffic activities,recreational activities and physical exercise were 35min/d,5.71min/d and 38.57min/d for the semi-arid group,which were significantly higher than the wet group(28.57min/d,3.43min/d and 32.00min/d)and the rainy group(24.29min/d,0.00min/d and 31.43min/d)(P < 0.001).The time for traffic activities,recreational activities,Domestic activities and physical exercise were 14.29min/d,0.00min/d,0.00min/d and 29.3min/d for the comfortable group,which were significantly higher than the hot group(14.29min/d,0.00min/d,0.00min/d and 29.3min/d)(P<0.001).(3)Affecting factors for MVPA obtained from logistics regressionDifferent gender,age,sleep time,SES and rainfall levels are important influencing factors on children and adolescents' MVPA attainment.The probability of MVPA deficiency was higher in the groups of "girls"(OR=1.38,P<0.001),"16~18 years old"(OR=2.1,P<0.001),"sleep time?6h"(OR=1.26,P=0.027),"medium SES"(OR=1.17,P=0.049)," rainy "(OR=1.61,P<0.001),and " wet "(OR=1.32,P=0.013).Conclusion(1)The overall PA of children and adolescents in provincial capitals of China was poor(with the lowest in Shanghai and Changsha),mainly manifested by the high rate of MVPA deficiency.The PA programs tended to be simple and lack of physical exercise.(2)The MVPA deficiency rate of girls was higher than that of boys;The rate of MVPA deficiency was higher among 16~18 years old than among other age groups.In addition,decreased physical exercise was caused by severely lack of sleep time,decreased active traffic activities caused by middle and high SES families,decreased PA time caused by wet,rainy were important reasons for the high MVPA deficiency rate among children and adolescents in provincial capitals of China.