Exposure to Smartphones and Tablets, Physical Activity and Sleep in Children From 5 to 10 Years Old: A Systematic Review and Meta-Analysis.

OBJECTIVE: To conduct a systematic review and meta-analysis to verify the association between smartphone/tablet exposure and physical activity and sleep in children from 5 to 10 years old. Data Source: This study followed the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and included studies that met eligibility criteria based on the "PECO" strategy: participants (children from 5 to 10 years old), exposure (smartphone and tablet use), and outcome (physical activity and sleep). STUDY INCLUSION AND EXCLUSION CRITERIA: The inclusion criteria were observational studies published in indexed scientific journals and written in Portuguese, English, and Spanish that verified the association of exposure to smartphones/tablets with physical activity and sleep in children aged 5 to 10 years of both sexes. Studies were considered eligible only if they met the previous criteria. Data Extraction: The search was conducted in January 2023 on databases from electronic journals without the restriction of the period. To meta-analyze were extracted and grouped using models of fixed and random effects, the coefficients Odds Ratio (OR), Beta (ß), Standard Error (SE), and Confidence Intervals of 95% (95%CI). Data Synthesis: 2396 potentially relevant papers were identified, and 17 met the inclusion criteria. RESULTS: It can be verified that there was an inverse association between smartphones with physical activity and sleep. Studies indicate that for every additional hour of smartphone and tablet use, sleep can be expected to decrease by an average of 11 minutes (ß = - 0.11; 95%CI = -0.13; -0.09). Children using smartphones and tablets were 1.79 times (OR = 1.79; 95%CI = 1.72-1.86) more likely to have shorter sleep duration and 1.53 times (OR = 1.53; 95%CI = 1.41-1.65) more likely to have worse sleep quality. Children with shorter smartphone and tablet usage were 1.19 times more likely to be active (OR = 1.19; 95% CI = 1.03-1.37). CONCLUSION: Children of 5 to 10 years who are more often exposed to smartphones and tablets are prone to have worse quality and quantity of sleep, as well as less practice of physical activity. Health promotion actions can be encouraged based on the results, aiming to reduce the use time of these devices and improve children's health and quality of life.

Is Greater Social Support from Parents and Friends Related to Higher Physical Activity Levels among Adolescents?

Increasing physical activity levels during adolescence have been put on the agenda by several researchers. This study verified the association between social support from parents and friends and different amounts of moderate-to-vigorous physical activity (MVPA) among adolescents in public school. The present study had a cross-sectional design and included a representative sample of 1984 adolescents (aged 15-17). The ASAFA (Apoio Social para prática de Atividade Física para Adolescentes) scale and the QAFA (Questionário de Atividade Física para Adolescentes) were used to determine social support and physical activity, respectively. For statistical analysis, a conceptual model for structured equations and weighted least squares mean and variance adjusted were applied. Social support from parents increased the odds of engaging in 180 min/week of MVPA by 46.7%, 47.8% for 300 min/week, and 45.5% for 420 min/week. Social support from friends showed similar relations trends: 23.8% for 180 min/week, 23.6% for 300 min/week, and 21.2% for 420 min/week. Social support from parents and friends increased the probability of adolescents reaching the amounts of physical activity investigated. The results indicate that greater social support (from parents and friends) was associated with a higher level of MVPA in Brazilian adolescents.

Clustering of Obesogenic Behaviors Associated With Bullying Roles Among 100,794 Adolescents.

Obesogenic behaviors have been individually associated with bullying during adolescence. However, physical activity, sedentary behavior, and diet manifest themselves in synergy and even behavioral profiles in which positive and negative behaviors coexist can be more positively associated with psychosocial outcomes. The present study aimed to analyze the association between clusters of obesogenic behaviors and different bullying roles in Brazilian adolescents. This cross-sectional study used data from the Brazilian School-based Health Survey-PENSE, 2015. A total of 100,794 male and female adolescents of the ninth-grade elementary school participated in the study. Students responded to an electronic questionnaire. Clusters of obesogenic behavior consisted of physical activity, exposure to sedentary behavior, and diet, and the different roles in bullying were: participant, victim, bully, and bully-victim. Binary logistic regression with 95% confidence intervals (CI) was used for data analysis (p < .05). Multiple adjustments and complex sampling procedures were employed. Adolescents in the cluster "Health-promoting sedentary behavior and Diet" had reduced chances of participating in bullying (odds ration [OR] = 0.70; 95% CI [0.64, 0.76]), of being a victim (OR = 0.87; 95% CI = 0.76-0.99), and being the bully (OR = 0.65; 95% CI [0.59, 0.71]); and those from the cluster "Health-promoting physical activity and Diet" had reduced chances of participating (OR = 0.81; 95% CI [0.76, 0.87]), being a victim of bullying (OR = 0.86; 95% CI [0.76, 0.98]), being the bully (OR = 0.79; 95% CI [0.72, 0.85]), and being a bully-victim (OR = 0.74; 95% CI [0.61, 0.90]), when compared to those from the "health-risk" cluster in the adjusted analysis. Clusters of obesogenic behavior may reduce adolescent bullying: victim, bully, and bully-victim benefit when exposed to healthier behavioral profiles. The school setting must recognize bullying as a problem and therefore simultaneously promote multi-component interventions to tackle physical activity, sedentary behavior, and eating behavior. Outcomes other than obesity should be acknowledged when promoting obesogenic behaviors.

Association of sex, sexual maturation, age group, economic class, and nutritional status with the different cutoff points of screen time in adolescents / Associação entre sexo, maturação sexual, faixa etária, classe econômica e estado nutricional com os diferentes pontos de corte do tempo de tela em adolescentes

Abstract Objectives: to estimate the prevalence of adolescents' screen time in three different scenarios and possible associations with gender, sexual maturation, age group, economic class, and nutritional status. Methods: a cross-sectional study conducted with a representative sample of 3,979 adolescents from Greater Curitiba. Screen time (television, computer, and video game) was self-reported and categorized as ≤2h/day, >2 to ≤4h/day, and >4h/day. Ordinal logistic regression tested the associations. Results: the sample consisted of adolescents of 14.60±1.88 years old, most girls (51.2%). The prevalence of screen time >4h/day was 89.3%. Girls (OR=0.61; CI95%=0.49-0.76) and the older age groups ("14 to 16 years" OR=0.29; CI95%=0.22-0.39, and "17 to 19 years" OR=0.11; CI95%=0.08-0.16) were less likely to be in the groups of higher screen time. Conclusions: screen time above four hours seems to be the most prevalent among adolescents. Older girls and teens are less likely to have higher screen time.

Resumo Objetivos: estimar a prevalência de tempo de tela de adolescentes em três diferentes cenários e possíveis associações com sexo, maturação sexual, faixa etária, classe econômica e estado nutricional. Métodos: estudo transversal realizado com amostra representativa de 3.979 adolescentes da Grande Curitiba. O tempo de tela (televisão, computador e videogame) foi autorrelatado e categorizado em ≤2h/dia, >2 a ≤4h/dia e >4h/dia. A regressão logística ordinal testou as associações. Resultados: amostra com idade média de 14,60±1,88 anos, formada por 51,2% de meninas.A prevalência de tempo de tela >4h/dia foi de 89,3%. Meninas (OR=0,61; IC95%=0,49-0,76) e os grupos de idade mais velhos ("14 a 16 anos" OR=0,29; IC95%=0,22-0,39 e "17 a 19 anos" OR=0,11; IC95%=0,08-0,16) eram menos propensos a estar nos grupos de maior tempo de tela. Conclusões: o tempo de tela acima de quatro horas parece ser o mais prevalente entre os adolescentes. Meninas e adolescentes mais velhos são menos propensos ao maior tempo de tela.

Time spent in different sedentary activity domains across adolescence: a follow-up study

Abstract Objective: This longitudinal study aimed to verify possible changes in the time spent in sedentary activities occurring as screen-time, educational, cultural, social, and transportation domains in a sample of Brazilian adolescents between 2015 and 2017. Methods: It is a longitudinal prospective study with 586 adolescents from 12 to 15 years old at the Baseline (2015) enrolled in 14 public schools from Curitiba, Brazil. The Adolescent Sedentary Activity Questionnaire assessed the time spent in sedentary activities in five domains (recreational screen-time, educational, cultural, social, and transportation). A series of linear random effects regressions analyzed changes in the sedentary time between 2015 and 2017, with p < .05. Results: Overall, 323 adolescents dropped out of the study resulting in a retention rate of 44.9%. The overall sedentary time remained stable from 2015 to 2017 (-3.98 min/day, 95%CI: -15.39; 7.42). The screen-time decreased (-22.22 min/day, 95%CI: -30.30; -14.15), and educational (8.29 min/day, 95% CI: 3.52; 13.06), cultural (3.41 min/day, 95% CI: 0.66; 6.15) and social sedentary activities (8.20 min/day, 95% CI: 2.06; 14.34) increased from 2015 to 2017. Conclusion: Significant reductions in screen-time were evidenced along with increases in time spent on other sedentary activities of educational, cultural, and social nature.

Time spent in different sedentary activity domains across adolescence: a follow-up study.

OBJECTIVE: This longitudinal study aimed to verify possible changes in the time spent in sedentary activities occurring as screen-time, educational, cultural, social, and transportation domains in a sample of Brazilian adolescents between 2015 and 2017. METHODS: It is a longitudinal prospective study with 586 adolescents from 12 to 15 years old at the Baseline (2015) enrolled in 14 public schools from Curitiba, Brazil. The Adolescent Sedentary Activity Questionnaire assessed the time spent in sedentary activities in five domains (recreational screen-time, educational, cultural, social, and transportation). A series of linear random effects regressions analyzed changes in the sedentary time between 2015 and 2017, with p < .05. RESULTS: Overall, 323 adolescents dropped out of the study resulting in a retention rate of 44.9%. The overall sedentary time remained stable from 2015 to 2017 (-3.98 min/day, 95%CI: -15.39; 7.42). The screen-time decreased (-22.22 min/day, 95%CI: -30.30; -14.15), and educational (8.29 min/day, 95% CI: 3.52; 13.06), cultural (3.41 min/day, 95% CI: 0.66; 6.15) and social sedentary activities (8.20 min/day, 95% CI: 2.06; 14.34) increased from 2015 to 2017. CONCLUSION: Significant reductions in screen-time were evidenced along with increases in time spent on other sedentary activities of educational, cultural, and social nature. KeywordsSedentary behavior, Adolescent health, Longitudinal studies.

[Changes in tobacco and alcoholic beverage consumption among adolescents from Curitiba in the State of Paraná: a longitudinal study]. / Modificações do consumo de cigarros e bebidas alcoólicas em adolescentes de Curitiba, Paraná: um estudo longitudinal.

The scope of this study was to verify alterations in cigarette and alcohol consumption in a sample of adolescents from the state education system of the city of Curitiba in the State of Paraná between 2015 and 2017. It involved a longitudinal prospective cohort study conducted with 799 adolescents (11 to 15 years of age) between 2015 and 2017. The Youth Risk Behavior Surveillance System (YRBS) questionnaire evaluated mild and excessive alcohol and tobacco consumption. Modifications of alcohol and tobacco consumption were evaluated through Generalizable Estimating Equation (GEE) models with Poisson distribution to obtain Incidence Risk Ratios (IRR) with 95% confidence intervals (95%CI). The "time" variable was treated as an independent variable along with other possible predictors (gender, age bracket, nutritional status, socioeconomic level, head of household education, physical activity and screen time). Tobacco consumption (IRR= 1,32, 95%CI = 1,02; 1,71), mild (IRR= 1,32, 95%CI = 1,13; 1,53) and excessive (IRR= 1,21, 95%CI = 1,04; 1,40) alcohol consumption increased between 2015 and 2017. This study indicates that adolescents participating in this research are modifying their behaviors towards a less healthy lifestyle.

A presente investigação objetivou verificar modificações no consumo de cigarro e álcool em uma amostra de adolescentes do sistema estadual de ensino da cidade de Curitiba, Paraná, Brasil entre 2015 e 2017. Estudo longitudinal de coorte prospectivo realizado com 799 adolescentes, entre 11 e 15 anos. O consumo leve e excessivo de álcool e de cigarro foram avaliados através do questionário Youth Risk Behavior Survey (YRBS). Modificações do consumo de álcool e cigarro foram avaliadas através de modelos de Equação de Estimação Generalizável com distribuição de Poisson para obtenção de razões de taxas de incidência (RTI) com intervalos de confiança de 95% (IC95%). A variável "tempo" foi tratada como variável independente, juntamente com demais possíveis preditores (sexo, faixa etária, estado nutricional, nível socioeconômico, escolaridade do chefe da família, atividade física e tempo em tela). O consumo de cigarros (RTI= 1,32, IC95%= 1,02; 1,71), consumo leve (RTI= 1,32, IC95%= 1,13; 1,53) e excessivo de álcool (RTI= 1,21, IC95%= 1,04; 1,40) cresceram significativamente entre 2015 e 2017. O presente estudo denota que os adolescentes participantes desta investigação estão modificando seus comportamentos em direção a um estilo de vida menos saudável.

Modificações do consumo de cigarros e bebidas alcoólicas em adolescentes de Curitiba, Paraná: um estudo longitudinal / Changes in tobacco and alcoholic beverage consumption among adolescents from Curitiba in the State of Paraná: a longitudinal study

Resumo A presente investigação objetivou verificar modificações no consumo de cigarro e álcool em uma amostra de adolescentes do sistema estadual de ensino da cidade de Curitiba, Paraná, Brasil entre 2015 e 2017. Estudo longitudinal de coorte prospectivo realizado com 799 adolescentes, entre 11 e 15 anos. O consumo leve e excessivo de álcool e de cigarro foram avaliados através do questionário Youth Risk Behavior Survey (YRBS). Modificações do consumo de álcool e cigarro foram avaliadas através de modelos de Equação de Estimação Generalizável com distribuição de Poisson para obtenção de razões de taxas de incidência (RTI) com intervalos de confiança de 95% (IC95%). A variável "tempo" foi tratada como variável independente, juntamente com demais possíveis preditores (sexo, faixa etária, estado nutricional, nível socioeconômico, escolaridade do chefe da família, atividade física e tempo em tela). O consumo de cigarros (RTI= 1,32, IC95%= 1,02; 1,71), consumo leve (RTI= 1,32, IC95%= 1,13; 1,53) e excessivo de álcool (RTI= 1,21, IC95%= 1,04; 1,40) cresceram significativamente entre 2015 e 2017. O presente estudo denota que os adolescentes participantes desta investigação estão modificando seus comportamentos em direção a um estilo de vida menos saudável.

Abstract The scope of this study was to verify alterations in cigarette and alcohol consumption in a sample of adolescents from the state education system of the city of Curitiba in the State of Paraná between 2015 and 2017. It involved a longitudinal prospective cohort study conducted with 799 adolescents (11 to 15 years of age) between 2015 and 2017. The Youth Risk Behavior Surveillance System (YRBS) questionnaire evaluated mild and excessive alcohol and tobacco consumption. Modifications of alcohol and tobacco consumption were evaluated through Generalizable Estimating Equation (GEE) models with Poisson distribution to obtain Incidence Risk Ratios (IRR) with 95% confidence intervals (95%CI). The "time" variable was treated as an independent variable along with other possible predictors (gender, age bracket, nutritional status, socioeconomic level, head of household education, physical activity and screen time). Tobacco consumption (IRR= 1,32, 95%CI = 1,02; 1,71), mild (IRR= 1,32, 95%CI = 1,13; 1,53) and excessive (IRR= 1,21, 95%CI = 1,04; 1,40) alcohol consumption increased between 2015 and 2017. This study indicates that adolescents participating in this research are modifying their behaviors towards a less healthy lifestyle.

Aplicativos para estimular a prática de atividade física em crianças e adolescentes brasileiros / Smatphone applications to stimulate physical activity in brazilian children and adolescents

Este estudo objetivou avaliar a qualidade de aplicativos para estimular a prática de atividade física de crianças e adolescentes brasileiros. Foi conduzida uma busca sistemática de aplicativos em português nas plataformas iTunese PlayStore, utilizando os seguintes termos: nível de atividades física, atividade física, aptidão física, exercício, exercício físico, atividade motora, esporte, caminhada, comportamento sedentário e inativo. A qualidade dos aplicativos foi avaliada através da Mobile App Rating Scale (MARS). A presença ou ausência de técnicas de mudança de comportamentos foi avaliada usando a taxonomia de técnicas de mudanças de comportamentos. A relação entre a qualidade dos aplicativos a as técnicas de mudanças de comportamento foram verificadas pelo coeficiente de correlação de Kendall's Tau. Quatro aplicativos atenderam a todos os critérios e foram incluídos na análise, apresentando qualidade aceitável. Sobre as técnicas de mudança de comportamentos, apenas o feedback dos usuários é comum a todos os aplicativos. Aplicativos não são baseados em recomendações para promoção da atividade física.

Evaluate the quality of apps to stimulate the practice of physical activity of Brazilian children and adolescents. We conducted a systematic search for applications in Portuguese on iTunes, and PlayStore platforms were conducted employing the following terms: level of physical activity, physical activity, physical fitness, exercise, physical exercise, motor activity, sport, walks, sedentary and inactive behavior. The quality of applications was evaluated by the Mobile App Rating Scale (MARS). The presence or absence of techniques for behavior change was evaluated by the taxonomy of behavior change techniques. Kendall's Tau correlation coefficient verified the relationship between the quality of the applications and the techniques of behavior changes. Four applications met all criteria and were included in the analysis, with reasonable quality. Regarding to techniques of behavior switching, only users' feedback was common to all applications. Applications were not based on recommendations for promoting physical activity.

[Insufficient physical activity levels and high screen time among adolescents: impact of associated factors]. / Nível insuficiente de atividade física e elevado tempo de tela em adolescentes: impacto de fatores associados.

The scope of this study was to verify the impact of associated factors with insufficient physical activity levels and high screen time among adolescents. A cross-sectional and representative study was conducted with 899 public high school adolescents from São José dos Pinhais, Paraná, Brazil. It involved measurement of physical activity levels and screen time and classification according to the norms of the World Health Organization and the American Academy of Pediatrics. The factors associated with insufficient physical activity levels and high screen time were gender, sexual maturation, social support and self-efficacy in terms of physical activity. Poisson regression was applied to test the associations. Population attributable fraction (PAF) and relative risk reduction (RRR) calculated the impact of associated factors with insufficient physical activity levels and high screen time among adolescents. In the combined presence of insufficient physical activity levels with high screen time, the female sex presented PAF = 13.04, a post-pubertal stage PAF = 9.91 and social support presented RRR = 31.00. The findings suggest that being female and post-pubescent are risk factors, while social support is a protective factor, for combined insufficient physical activity levels and high screen time among adolescents.

Verificar o impacto de fatores associados ao nível insuficiente de atividade física e elevado tempo de tela em adolescentes. Estudo transversal, representativo, com 899 alunos de ensino médio da rede pública de São José dos Pinhais, Paraná, Brasil. Foram mensurados o nível de atividade física e o tempo de tela e classificados respectivamente de acordo com as recomendações da Organização Mundial da Saúde e da American Academy of Pediatrics. Os fatores associados para o nível insuficiente de atividade física e tempo de tela foram: sexo, maturação sexual, apoio social e autoeficacia para a prática de atividade física. As associações foram testadas com a regressão de Poisson. E o impacto dos fatores associados ao nível insuficiente de atividade física e do elevado tempo de tela foram calculadas pela fração atribuível populacional (FAP) e a redução relativa do risco (RRR). Na presença combinada do nível insuficiente de atividades físicas com o elevado tempo de tela, o sexo feminino apresentou uma FAP = 13,04, o estágio pós-púbere FAP = 9,91 e o apoio social apresentou uma RRR = 31,00. Os achados sugerem sexo feminino e estar no estágio pós-púbere como fatores de risco, e apoio social como fator protetor a presença combinada do nível insuficiente de atividade física e do elevado tempo de tela.

CORRELATES OF PHYSICAL ACTIVITY IN ADOLESCENTS OF PUBLIC SCHOOLS IN CURITIBA, PARANÁ, BRAZIL.

OBJECTIVE: To verify the association of nutritional status, biological maturation, social support and self-efficacy with the physical activity level of 2,347 students of both sexes, aged between 11 and 15 years old, enrolled in state schools in the city of Curitiba, Paraná, Brazil. METHODS: Anthropometric measurements of body mass, height and sitting height were collected. The assessment of biological maturation was based on the analysis of the age at peak height and sexual maturity. The physical activity level, social support from parents and friends and self-efficacy were evaluated by self-reported questionnaires. Sex/age-specific body mass index (BMI) cutoff points identified the nutritional status. Gross and adjusted binary logistic regression were used to obtain odds (OR) ratios with 95% confidence intervals (95%CI), adopting p≤0.05 as significant. RESULTS: More than half (52.3%; n=1,227) of students were active, with boys in a higher proportion (64.1%; p≤0.01). The correlates of physical activity were: nutritional status (OR 1.25; 95%CI 1.01-1.56), early somatic maturation (OR 0.71; 95%CI 0.54-0.93), moderate (OR 1.85; 95%CI 1.50-2.30) and high social support from parents (OR 2.70; 95%CI 2.11-3.42) and high social support from friends (OR 1.78; 95%CI 1.42-2.24). CONCLUSIONS: Nutritional status, early somatic maturation, social support of parents and friends were correlates of physical activity. Overweight girls with moderate and high parental support and boys with greater social support from parents and friends were more active. Girls with early somatic maturation were less active.

Correlates of physical activity in adolescents of public schools in curitiba, paraná, brazil / Correlatos da atividade física em adolescentes de escolas públicas de curitiba, paraná

ABSTRACT Objective: To verify the association of nutritional status, biological maturation, social support and self-efficacy with the physical activity level of 2,347 students of both sexes, aged between 11 and 15 years old, enrolled in state schools in the city of Curitiba, Paraná, Brazil. Methods: Anthropometric measurements of body mass, height and sitting height were collected. The assessment of biological maturation was based on the analysis of the age at peak height and sexual maturity. The physical activity level, social support from parents and friends and self-efficacy were evaluated by self-reported questionnaires. Sex/age-specific body mass index (BMI) cutoff points identified the nutritional status. Gross and adjusted binary logistic regression were used to obtain odds (OR) ratios with 95% confidence intervals (95%CI), adopting p≤0.05 as significant. Results: More than half (52.3%; n=1,227) of students were active, with boys in a higher proportion (64.1%; p≤0.01). The correlates of physical activity were: nutritional status (OR 1.25; 95%CI 1.01-1.56), early somatic maturation (OR 0.71; 95%CI 0.54-0.93), moderate (OR 1.85; 95%CI 1.50-2.30) and high social support from parents (OR 2.70; 95%CI 2.11-3.42) and high social support from friends (OR 1.78; 95%CI 1.42-2.24). Conclusions: Nutritional status, early somatic maturation, social support of parents and friends were correlates of physical activity. Overweight girls with moderate and high parental support and boys with greater social support from parents and friends were more active. Girls with early somatic maturation were less active.

RESUMO Objetivo: Verificar a associação do estado nutricional, da maturação biológica, do apoio social e da autoeficácia com o nível de atividade física de 2.347 escolares, de ambos os sexos, com idades entre 11 e 15 anos, de escolas estaduais da cidade de Curitiba, Paraná. Métodos: Foram coletadas as medidas antropométricas de massa corporal, estatura e altura sentada. A avaliação da maturação biológica foi realizada pelas análises da idade do pico de velocidade de altura e maturação sexual. O nível de atividade física, o apoio social dos pais e dos amigos e a autoeficácia foram analisados por questionários autorreportados. O estado nutricional foi obtido por meio de pontos de corte de índice de massa corpórea (IMC) específicos para idade e sexo. Razões de chances com intervalos de confiança de 95% (IC95%) foram obtidas por meio da regressão logística binária bruta e ajustada, adotando-se p<0,05. Resultados: Pouco mais da metade (52,3%; n=1.227) dos escolares é ativa, sendo os meninos em maior proporção (64,1%; p≤0,01). Foram associados com atividade física: estado nutricional (Odds Ratio [OR] 1,25; IC95% 1,01-1,56), maturação somática precoce (OR 0,71; IC95% 0,54-0,93), moderado e elevado apoio social dos pais (OR 1,85; IC95% 1,50-2,30 e OR 2,70; IC95% 2,11-3,42, respectivamente) e elevado apoio social dos amigos (OR 1,78; IC95% 1,42-2,24). Conclusões: O estado nutricional, a maturação somática precoce, o apoio social dos pais e dos amigos foram correlatos da atividade física. Meninas com excesso de peso e com moderado e elevado apoio social dos pais, e meninos com maior apoio social dos pais e dos amigos foram mais ativos, enquanto meninas maturadas precocemente, menos ativas.

Associations between physical activity, sedentary behavior, and health risk behaviors among adolescents from a city in Southern Brazil / Associações entre atividade física, comportamento sedentário e comportamentos de risco à saúde entre adolescentes de uma cidade do Sul do Brasil

This study examined the independent and combined associations of physical activity (PA) and sedentary behavior (SB) with health risk behaviors in Brazilian adolescents. Participants were 893 adolescents (454 girls) from Curitiba, Brazil. The Youth Activity Profile questionnaire evaluated PA and the Adolescent Sedentary Questionnaire evaluated SB. The Youth Risk Behavior Surveillance System ( YRBS) questionnaire evaluated fruit, vegetable, alcohol, and tobacco consumption. Binary Logistic regression measured the independent and combined associations of PA and SB with risk behaviors. PA was inversely associated with low fruit (OR = 0.30; 95%CI: 0.18-0.51) and vegetable consumption (OR = 0.43; 95%CI: 0.25-0.73), and tobacco use (OR = 0.52; 95%CI: 0.29-0.89). However, PA was positively associated with mild (OR = 1.54; 95%CI: 1.08-2.19) and excessive alcohol use (OR = 1.53; 95%CI: 1.01-2.33). Higher levels of PA were associated with reduced risks of smoking and healthier eating patterns, but higher likelihood of alcohol consumption

Este estudo examinou as associações independentes e combinadas de atividade física (AF) e do comportamento sedentário (CS) com comportamentos de risco à saúde em adolescentes brasileiros. Participaram do estudo 893 adolescentes (454 meninas) de Curitiba, Brasil. O questionário Youth Activity Profile avaliou a AF e o Questionário de atividades sedentárias dos adolescentes avaliou o CS. O questionário Youth Risk Behavior Surveillance System (YRBS) avaliou o consumo de frutas, vegetais, álcool e tabaco. A regressão logística binária avaliou as associações independentes e combinadas de AF e CS com comportamentos de risco. AF foi inversamente associado com baixo consumo de frutas (OR = 0,30; IC95%: 0,18-0,51), de vegetais (OR = 0,43; IC95%: 0,25-0,73) e uso de tabaco (OR = 0,52; IC95%: 0,29-0,89). No entanto, a AF foi positivamente associada com uso moderado (OR = 1,54; IC95%: 1,08-2,19) e uso excessivo de álcool (OR = 1,53; IC95%: 1,01-2,33). Níveis mais altos de AF foram associados com riscos reduzidos de fumar e padrões alimentares mais saudáveis e com maior probabilidade de consumo de álcool

Impact of physical activity correlates in the isolated and combined presence of insufficient level of physical activity and high screen time among adolescents / Impacto dos correlatos da atividade física na presença isolada e combinada de nível insuficiente de atividade física e elevado tempo de tela em adolescentes

ABSTRACT Objective: To identify the impact of physical activity correlates with the isolated and combined presence of insufficient physical activity and high screen time among adolescents. Methods: A cross-sectional representative study was carried out with a sample of 786 adolescents (16.0±1.0 years; 53.9% girls) randomly selected in the schools of São José dos Pinhais, Paraná, Southern Brazil. The physical activity correlates analyzed were sex, nutritional status, economic class and sexual maturation. Physical activity level and screen time were measured and classified according to reference criteria. The associations were tested with Poisson regression and the population attributable fraction (PAF) verified the impact of correlates on the combined presence of insufficient level of physical activity and high screen time by the prevalence ratio (PR). Results: Among the studied adolescents, 84.7% (n=666) were considered insufficiently active, 96.4% (n=758) reported high screen time and 82.1% (n=645) presented the combined presence of these behaviors. The female sex and the high economic status were positively associated with the insufficient level of physical activity (PR=1.19; 95% confidence interval - 95%CI 1.12-1.27; PAF=15.97 - female/adjusted; PR=1,1; 95%CI 1,01-1,19; PAF=9,09 - high/adjusted class). The female sex also was positively associated to high screen time after adjustments (PR=1.18; 95%CI 1.10-1.27; PAF=15.25). The female sex was positively associated with the combined presence of these behaviors (PR=1.18; 95%CI 1.10-1.27) with a 15.25% impact on these behaviors. Conclusions: Physical activity correlates can have an impact on the insufficient level of physical activity and high screen time, especially among girls.

RESUMO Objetivo: Identificar o impacto dos correlatos da atividade física (AF) com a presença isolada e a combinada da prática insuficiente de AFs e do elevado tempo de tela em adolescentes. Métodos: Estudo transversal, representativo, com amostra de 786 adolescentes (16,2±1,1 anos; 53,9% de meninas) selecionados aleatoriamente nas escolas de São José dos Pinhais, PR. Foram analisados: sexo, estado nutricional, classe econômica e maturação sexual. Foram mensurados o nível de AF e o tempo de tela. As associações foram testadas com a regressão de Poisson e a fração atribuível populacional (FAP) verificou o impacto dos correlatos na presença combinada do nível insuficiente de AF e do elevado tempo de tela pela razão de prevalência (RP). Resultados: Foram considerados insuficientemente ativos 84,7% (n=666), com elevado tempo de tela, 96,4% (n=758), e 82,1% (n=645) dos adolescentes apresentaram a presença combinada desses comportamentos. O sexo feminino e a classificação econômica elevada estiveram positivamente associados aos níveis insuficientes de AF (RP=1,19; intervalo de confiança de 95% [IC95%] 1,12-1,27; FAP=15,97 - feminino/ajustado; RP=1,1; IC95% 1,01-1,19; FAP=9,09 - classe elevada/ajustado). O primeiro também se apresentou positivamente associado ao elevado tempo de tela após os ajustes (RP=1,18; IC95% 1,10-1,27; FAP=15,25) e mostrou-se associado positivamente à presença combinada desses comportamentos (RP=1,18; IC95% 1,10-1,27), com um impacto de 15,25% sobre essas condutas. Conclusões: Correlatos da AF podem ter impacto sobre o nível insuficiente de AFs e elevado tempo de tela, quando investigados de formas isolada e combinada, principalmente em relação às meninas.

IMPACT OF PHYSICAL ACTIVITY CORRELATES IN THE ISOLATED AND COMBINED PRESENCE OF INSUFFICIENT LEVEL OF PHYSICAL ACTIVITY AND HIGH SCREEN TIME AMONG ADOLESCENTS.

OBJECTIVE: To identify the impact of physical activity correlates with the isolated and combined presence of insufficient physical activity and high screen time among adolescents. METHODS: A cross-sectional representative study was carried out with a sample of 786 adolescents (16.0±1.0 years; 53.9% girls) randomly selected in the schools of São José dos Pinhais, Paraná, Southern Brazil. The physical activity correlates analyzed were sex, nutritional status, economic class and sexual maturation. Physical activity level and screen time were measured and classified according to reference criteria. The associations were tested with Poisson regression and the population attributable fraction (PAF) verified the impact of correlates on the combined presence of insufficient level of physical activity and high screen time by the prevalence ratio (PR). RESULTS: Among the studied adolescents, 84.7% (n=666) were considered insufficiently active, 96.4% (n=758) reported high screen time and 82.1% (n=645) presented the combined presence of these behaviors. The female sex and the high economic status were positively associated with the insufficient level of physical activity (PR=1.19; 95% confidence interval - 95%CI 1.12-1.27; PAF=15.97 - female/adjusted; PR=1,1; 95%CI 1,01-1,19; PAF=9,09 - high/adjusted class). The female sex also was positively associated to high screen time after adjustments (PR=1.18; 95%CI 1.10-1.27; PAF=15.25). The female sex was positively associated with the combined presence of these behaviors (PR=1.18; 95%CI 1.10-1.27) with a 15.25% impact on these behaviors. CONCLUSIONS: Physical activity correlates can have an impact on the insufficient level of physical activity and high screen time, especially among girls.

Social support, self-efficacy and level of physical activity of students aged 13-15 years / Apoio social, autoeficácia e o nível de atividade física em escolares de 13 a 15 anos

Abstract The aim of this study was to verify the relationship, the population attributable fraction (PAF) and the relative risk reduction (RRR) of social support and self-efficacy with level of physical activity in students. Probabilistic cross-sectional study with 1,472 students aged 13-15 years. Gender, age, social support from parents and friends, self-efficacy and levels of physical activity were evaluated through questionnaires. Data analysis was performed using Poisson regression with robust variance, PAF and RRR, adopting p≤0.05. A total of 56.1% (n = 826) of students were considered active, boys (68.7%) presenting the largest proportion. Social support from parents was positively associated with physical activity in boys (PR: 1.28, 95% CI: 1.12-1.48, PAF = 21.88) and girls (PR: 2.00; 95%CI: 1.59-2.51, PAF = 50.00). Social support from friends was positively associated with physical activity in boys (PR: 1.34, 95%CI: 1.16-1.54, PAF = 25.37) and girls (PR: 1.32, 95%CI: 1.06-1.64, PAF = 24.24). Self-efficacy was not associated with physical activity. Social support was associated with levels of physical activity, and PAF indicated that the absence of high social support from parents and friends might reduce the level of physical activity in adolescents.

Resumo Objetivou-se verificar a relação, a fração atribuível populacional (FAP) e a redução relativa do risco (RRR) do apoio social e autoeficácia com o nível de atividade física em escolares. Estudo transversal probabilístico com 1472 escolares de 13 a 15 anos. Foram avaliados sexo, idade, apoio social dos pais e dos amigos, autoeficácia e nível de atividade física através de questionários. Para análise dos dados utilizou-se regressão de Poisson com variância robusta, FAP e RRR, adotando p≤0,05. Foram considerados ativos 56,1% (n=826) dos escolares, sendo os meninos (68,7%) em maior proporção. O apoio social dos pais foi positivamente associado à prática de atividades física dos meninos (RP: 1,28;IC95%: 1,12-1,48; FAP=21,88) e das meninas (RP: 2,00; IC95%: 1,59-2,51; FAP=50,00). O apoio social dos amigos foi positivamente associado à prática de atividades físicas dos meninos (RP: 1,34; IC95% 1,16-1,54; FAP=25,37) e das meninas (RP: 1,32; IC95%: 1,06-1,64; FAP=24,24). A autoeficácia não se associou com atividade física. O apoio social apresentou-se associado com o nível de atividade física, e as análises da FAP indicaram que sem o elevado apoio social dos pais e amigos pode haver uma redução do nível de atividade física em adolecentes.

[Reproducibility of a questionnaire on physical activity among school students from 9 to 15 years of age]. / Reprodutibilidade de um questionário de atividade física em escolares de 9 a 15 anos de idade.

The objective of this study was to analyze the "test-retest" reproducibility of a questionnaire on physical activity among 1189 school students of both genders, from 9 to 15 years age in public schools in Curitiba/PR. The reproducibility of the questionnaire was determined by the repeated measures procedure called "test-retest", with an interval of one week between applications. For data analysis the Intraclass Correlation Coefficient (ICC), the percentage of correlation, the Kappa index, adjusted Kappa (Kappa PABAK) and Bland-Altman scatter diagram were used. Statistical analyses were performed using SPSS 21.0 adopting a 5% significance level. All ICC were higher than 0.80. The correlation between the application replicas of the questionnaire was moderate, Kappa ranging from 0.51 to 0.61. There was a correlation between the questionnaire applications, the average difference between the first and second being equal to 106.49 min/wk (IC95%: 79.05-133.92) with limits of correlation ranging from 1070.97 (+2SD) to -857.99 (-2SD) min/week. In conclusion, the survey analyzed in this study showed satisfactory levels of reproducibility, having the possibility of being used to measure physical activity in both children and adolescents.

O objetivo deste estudo foi analisar a reprodutibilidade "teste-reteste" de um questionário de Atividade Física em 1.189 escolares, de ambos os sexos, de 9 a 15 anos da rede pública de ensino de Curitiba/PR. A reprodutibilidade do questionário foi determinada pelo procedimento de medidas repetidas "teste-reteste" com uma semana de intervalo entre as aplicações. Para a análise dos dados utilizou-se o Coeficiente de Correlação Intraclasse (CCI), o percentual de concordância, o índice Kappa, o Kappa ajustado (Kappa PABAK) e o diagrama de dispersão de Bland-Altman. As análises estatísticas foram efetuadas no SPSS 21.0 adotando-se um nível de significância de 5%. Todos os CCI foram superiores a 0,80. A concordância entre as réplicas de aplicação do questionário foi moderada, Kappa variando de 0,51 a 0,61. Verificou-se concordância entre as réplicas de aplicação do questionário, sendo a diferença média entre a primeira e a segunda igual a 106,49 min/semana (IC95%: 79,05-133,92) com limites de concordância variando de 1.070,97 (+2DP) a -857,99 (-2DP) min/semana. Conclui-se que o questionário analisado neste estudo apresentou níveis satisfatórios de reprodutibilidade podendo ser utilizado para mensurar a atividade física tanto em crianças quanto em adolescentes.

Fidedignidade de um questionário de comportamento sedentário em escolares / Reliability of a sedentary behavior questionnaire in students / Fidedignidad de un cuestionario de conducta sedentaria de escolares

OBJETIVO: Avaliar a fidedignidade de um questionário de comportamento sedentário. MÉTODOS: Estudo transversal realizado com 1.119 escolares, de 9 a 15 anos de idade, de sete escolas públicas de Curitiba, Paraná, Brasil, entre março e dezembro de 2015. O questionário é composto por 13 itens, divididos em cinco aspectos (tempo de tela, educacional, cultural, social e transporte), em que os participantes relatam o tempo gasto em atividades sedentárias (horas e/ou minutos) durante uma semana típica. Para a análise de fidedignidade do questionário, realizaram-se duas aplicações do questionário e o coeficiente de Correlação Intraclasse avaliou a reprodutibilidade, o diagrama de dispersão de Bland Altman, a concordância entre as duas medidas teste-reteste e o alpha de Cronbach, a consistência interna do questionário, adotando-se o nível de significância de 5%. RESULTADOS: O coeficiente de correlação intraclasse e o alpha de Cronbach apresentaram valores maiores que 0,70, sendo maiores nos dias de semana do que nos fins de semana. As duas aplicações do questionário apresentaram uma diferença média de 228,27 minutos/semana, com intervalo de confiança de 95%, de 175,86 a 280,68. O limite de concordância variou de 2.015,33 a 1.558,79 minutos/semana. CONCLUSÃO: O questionário apresentou fidedignidade satisfatória, podendo ser utilizado para mensurar o comportamento sedentário em escolares de 9 a 15 anos de escolas públicas.

OBJECTIVE: To evaluate the reliability of a sedentary behavior questionnaire. METHODS: Cross-sectional study with 1,119 students from 9 to 15 years old from seven public schools in Curitiba, Paraná, Brazil, between March and December 2015. The questionnaire consists of 13 items divided into five aspects (screen time, educational, cultural, social and transportation) in which the participants reported time spent in sedentary activities (hours and/or minutes) in a typical week. For the reliability analysis, two applications of the questionnaire were performed and the intraclass correlation coefficient evaluated the reproducibility, Bland­Altman scatter plot assessed the concordance between the two test-retest measurements, and Cronbach's alpha, the internal consistency of the questionnaire, adopting 5% as significance level. RESULTS: The intraclass correlation coefficient and Cronbach's alpha presented values greater than 0.70, being higher on weekdays than on weekends. The two applications of the questionnaire presented a mean difference of 228.27 minutes/week, with 95% confidence interval of 175.86 to 280.68. The limits of agreement ranged from 2,015.33 to -1,558.79 minutes/week. CONCLUSION: The questionnaire presented satisfactory reliability and can be used to measure sedentary behavior in students from 9 to 15 years old of public schools.

OBJETIVO: Evaluar la fidedignidad de un cuestionario de conducta sedentaria. MÉTODOS: Estudio transversal realizado con 1.119 escolares entre 9 y 15 años de edad de siete escuelas públicas de Curitiba, Paraná, Brasil, entre marzo y diciembre de 2015. El cuestionario tiene 13 ítems divididos en cinco aspectos (tiempo en la pantalla, educacional, cultural, social y transporte) en el cual los participantes relatan el tiempo gastado en las actividades sedentarias (las horas y/o los minutos) durante una semana típica. Para el análisis de la fidedignidad del cuestionario se realizaron dos aplicaciones del cuestionario. El coeficiente de Correlación Intraclase evaluó la reproductibilidad, el diagrama de dispersión de Bland Altman evaluó la concordancia entre las dos medidas test-retest y el alpha de Cronbach evaluó la consistencia interna del cuestionario adoptándose el nivel de significancia del 5%. RESULTADOS: El coeficiente de correlación intraclase y el alpha de Cronbach presentaron valores mayores que 0,70, siendo mayores en los días de la semana que en los fines de semana. Las dos aplicaciones del cuestionario presentaron una diferencia media de 228,27 minutos/semana con intervalo de confianza del 95%, entre 175,86 y 280,68. El límite de la concordancia ha variado entre 2.015,33 y 1.558,79 minutos/semana. CONCLUSIÓN: El cuestionario presentó la fidedignidad satisfactoria y puede ser utilizado para mensurar la conducta sedentaria de escolares entre 9 y 15 años de escuelas públicas.

Associação entre apoio social e nível de atividade física em adolescentes / Association between social support and physical activity level in adolescents

Analisar a associação do apoio social de pais e amigos com o nível de atividade física de adolescentes. Estudo transversal, com uma amostra de 952 adolescentes (15,72 ± 1,48 anos e 53,8% do sexo femi-nino). Foram avaliados diferentes tipos de apoio social para atividades físicas, provenientes dos pais e amigos. Um questionário foi utilizado para mensurar o nível de atividade física. O estado nutricional foi determinado com base no índice de massa corporal. As associações foram testadas por meio da regressão de Poisson, com variância robusta. O apoio social dos pais do tipo assistir a prática de ativi-dades físicas nos adolescentes eutróficos ("às vezes" ­ RP = 1,60; IC95%: 1,16-2,19 e "sempre" ­ RP = 1,82; IC95%: 1,09-3,04) e com sobrepeso ("às vezes" ­ RP = 3,26; IC95%: 1,23-8,63) e comentar positivamente sobre a prática de atividades físicas nos adolescentes eutróficos ("às vezes" ­ RP = 1,49; IC95%: 1,08-2,07) e com sobrepeso ("às vezes" ­ RP = 3,11; IC95%: 1,12-8,59) associaram-se ao nível de atividade física. O apoio social dos amigos do tipo praticar atividades junto nos adolescentes com sobrepeso ("sempre" ­ RP = 2,57; IC95%: 1,02-6,44) e assistir a prática de atividades físicas nos ado-lescentes eutróficos ("sempre" ­ RP = 1,52; IC95%: 1,01-2,32) e com sobrepeso ("sempre" ­ RP = 3,68; IC95%: 1,19-11,35) associaram-se ao nível de atividade física. O apoio social fornecido pelos pais e amigos foi associado a maior prática de atividades físicas em adolescentes eutróficos e com sobrepeso

To analyze the association of the social support of parents and friends with the physical activity level of nor-mal weight and overweight adolescents. A cross-sectional study with a sample of 952 adolescents (15.72 ± 1.48 years, 53.8% girls). Different types of social support for physical activities from parents and friends were evaluated. A questionnaire measured physical activity level. Body mass index evaluated nutritional status. Poisson regression, with robust variance tested the associations. Parents social support was associated with at-tend the physical activities for normal weight adolescents ("sometimes" ­ PR = 1.60; CI95%: 1.16-2.19 and "always" ­ PR = 1.82; CI95%: 1,09-3,04) and overweight ("sometimes" ­ PR = 3.26, CI95%: 1.23-8.63) and comments positively about physical activities for normal weight adolescents ("sometimes" ­ PR = 1.49; CI95%: 1.08-2.07) and overweight ("sometimes" ­ PR = 3.11; CI95%: 1.12-8.59). Friends social support was associated for practice activities together for overweight adolescents ("always" ­ PR = 2.57; CI95%: 1.02-6.44) and attend physical activity for normal weight adolescents ("always" ­ PR = 1.52; CI95%: 1.01-2.32) and overweight ("always" ­ PR = 3.68; CI95%: 1.19-11.35). Parents and friends social support associated with greater physical activity levels in both normal weight and overweight adolescents