DE-PASS best evidence statement (BESt): determinants of adolescents’ device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

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Abstract

Background

Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings.

Methods

A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874.

Results

Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found.

Conclusions

Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-024-19136-y.

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Most cited references 64

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The PRISMA 2020 statement: An updated guideline for reporting systematic reviews

Matthew J L Page, Joanne E. Mckenzie, Patrick Bossuyt … (2021)

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement, published in 2009, was designed to help systematic reviewers transparently report why the review was done, what the authors did, and what they found. Over the past decade, advances in systematic review methodology and terminology have necessitated an update to the guideline. The PRISMA 2020 statement replaces the 2009 statement and includes new reporting guidance that reflects advances in methods to identify, select, appraise, and synthesise studies. The structure and presentation of the items have been modified to facilitate implementation. In this article, we present the PRISMA 2020 27-item checklist, an expanded checklist that details reporting recommendations for each item, the PRISMA 2020 abstract checklist, and the revised flow diagrams for original and updated reviews.

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Risk‐of‐bias VISualization (robvis): An R package and Shiny web app for visualizing risk‐of‐bias assessments

Luke McGuinness, Julian P. T. Higgins (2020)

Despite a major increase in the range and number of software offerings now available to help researchers produce evidence syntheses, there is currently no generic tool for producing figures to display and explore the risk-of-bias assessments that routinely take place as part of systematic review. However, tools such as the R programming environment and Shiny (an R package for building interactive web apps) have made it straightforward to produce new tools to help in producing evidence syntheses. We present a new tool, robvis (Risk-Of-Bias VISualization), available as an R package and web app, which facilitates rapid production of publication-quality risk-of-bias assessment figures. We present a timeline of the tool's development and its key functionality.

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Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants

Regina Guthold, Gretchen Stevens, Leanne Riley … (2020)

Summary Background Physical activity has many health benefits for young people. In 2018, WHO launched More Active People for a Healthier World, a new global action on physical activity, including new targets of a 15% relative reduction of global prevalence of insufficient physical activity by 2030 among adolescents and adults. We describe current prevalence and trends of insufficient physical activity among school-going adolescents aged 11–17 years by country, region, and globally. Methods We did a pooled analysis of cross-sectional survey data that were collected through random sampling with a sample size of at least 100 individuals, were representative of a national or defined subnational population, and reported prevalence of of insufficient physical activity by sex in adolescents. Prevalence had to be reported for at least three of the years of age within the 10–19-year age range. We estimated the prevalence of insufficient physical activity in school-going adolescents aged 11–17 years (combined and by sex) for individual countries, for four World Bank income groups, nine regions, and globally for the years 2001–16. To derive a standard definition of insufficient physical activity and to adjust for urban-only survey coverage, we used regression models. We estimated time trends using multilevel mixed-effects modelling. Findings We used data from 298 school-based surveys from 146 countries, territories, and areas including 1·6 million students aged 11–17 years. Globally, in 2016, 81·0% (95% uncertainty interval 77·8–87·7) of students aged 11–17 years were insufficiently physically active (77·6% [76·1–80·4] of boys and 84·7% [83·0–88·2] of girls). Although prevalence of insufficient physical activity significantly decreased between 2001 and 2016 for boys (from 80·1% [78·3–81·6] in 2001), there was no significant change for girls (from 85·1% [83·1–88·0] in 2001). There was no clear pattern according to country income group: insufficient activity prevalence in 2016 was 84·9% (82·6–88·2) in low-income countries, 79·3% (77·2–87·5) in lower–middle-income countries, 83·9% (79·5–89·2) in upper–middle-income countries, and 79·4% (74·0–86·2) in high-income countries. The region with the highest prevalence of insufficient activity in 2016 was high-income Asia Pacific for both boys (89·0%, 62·8–92·2) and girls (95·6%, 73·7–97·9). The regions with the lowest prevalence were high-income western countries for boys (72·1%, 71·1–73·6), and south Asia for girls (77·5%, 72·8–89·3). In 2016, 27 countries had a prevalence of insufficient activity of 90% or more for girls, whereas this was the case for two countries for boys. Interpretation The majority of adolescents do not meet current physical activity guidelines. Urgent scaling up of implementation of known effective policies and programmes is needed to increase activity in adolescents. Investment and leadership at all levels to intervene on the multiple causes and inequities that might perpetuate the low participation in physical activity and sex differences, as well as engagement of youth themselves, will be vital to strengthen the opportunities for physical activity in all communities. Such action will improve the health of this and future young generations and support achieving the 2030 Sustainable Development Goals. Funding WHO.

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Author and article information

Contributors

Athanasios Kolovelonis: akolov@pe.uth.gr

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 26 June 2024

Publication date PMC-release: 26 June 2024

Publication date Collection: 2024

Volume: 24

Electronic Location Identifier: 1706

Affiliations

[1 ]Department of Physical Education and Sport Science, University of Thessaly, ( https://ror.org/04v4g9h31) 42 100 Karies, Trikala, Greece

[2 ]Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), ( https://ror.org/05xg72x27) Trondheim, Norway

[3 ]Department of Sport, Exercise and Rehabilitation, Northumbria University, ( https://ror.org/049e6bc10) Newcastle, UK

[4 ]Faculty of Education, University of Turku, ( https://ror.org/05vghhr25) Turku, Finland

[5 ]Department of Physical Education and Sport Sciences, Physical Activity for Health Centre, University of Limerick, ( https://ror.org/00a0n9e72) Limerick, Ireland

[6 ]Institute of Innovation and Sports Science, Lithuanian Sports University, ( https://ror.org/00hxk7s55) Kaunas, Lithuania

[7 ]Exercise Physiology Laboratory, OrthoSport Banja Luka, Banja Luka, Bosnia-Herzegovina

[8 ]Department of Psychological Methods, University of Amsterdam, ( https://ror.org/04dkp9463) Amsterdam, the Netherlands

[9 ]University College London, ( https://ror.org/02jx3x895) London, UK

[10 ]Department of Prevention and Evaluation, Leibniz, Institute for Prevention Research and Epidemiology – BIPS, ( https://ror.org/02c22vc57) Bremen, Germany

[11 ]Centre for Exercise Medicine, Physical Activity and Health, Sport and Exercise Sciences Research Institute, Ulster University, ( https://ror.org/01yp9g959) Belfast, UK

[12 ]GRID grid.412756.3, ISNI 0000 0000 8580 6601, Department of Movement, Human and Health Sciences, , University of Rome “Foro Italico”, ; Rome, Italy

[13 ]Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, ( https://ror.org/04nxkaq16) Cassino, Italy

[14 ]Faculty of Economics, Department of Psychology, Universita Cattolica del Sacro Cuore, ( https://ror.org/03h7r5v07) Milan, Italy

[15 ]GRID grid.412451.7, ISNI 0000 0001 2181 4941, Department of Medicine and Aging Sciences, , University “G. d’Annunzio” of Chieti-Pescara, ; Chieti, Italy

[16 ]Faculty of Sport and Physical Education, University of Novi Sad, ( https://ror.org/00xa57a59) Novi Sad, Serbia

[17 ]Department of Medical, Movement and Wellbeing Sciences, University of Naples “Parthenope”, ( https://ror.org/05pcv4v03) Naples, Italy

[18 ]Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, ( https://ror.org/04q12yn84) Oslo, Norway

[19 ]Laboratory of Sports Medicne, Department of Physical Education and Sports Science, Aristotle University of Thessaloniki, ( https://ror.org/02j61yw88) Thessaloniki, Greece

[20 ]GRID grid.414928.2, ISNI 0000 0004 0500 8159, Health Promotion and Evaluation, , National Institute of Public Health in Romania, ; Bucharest, Romania

[21 ]Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, ( https://ror.org/03x297z98) Kristiansand, Norway

[22 ]EPIUnit - Institute of Public Health, University of Porto, ( https://ror.org/043pwc612) Porto, Portugal

[23 ]Physical Activity for Health Cluster, Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, ( https://ror.org/00a0n9e72) Limerick, Ireland

[24 ]Institute of Sports and Sports Science, Karlsruhe Institute of Technology, ( https://ror.org/04t3en479) Karlsruhe, Germany

Article

Publisher ID: 19136

DOI: 10.1186/s12889-024-19136-y

PMC ID: 11202347

PubMed ID: 38926707

SO-VID: f724cbd6-5724-4d4a-9d95-27fb7ccab22d

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 25 October 2023

Date accepted : 13 June 2024

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ScienceOpen disciplines: Public health

Keywords: physical activity,adolescents,robust bayesian meta-analysis,risk of bias,grade

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ScienceOpen disciplines: Public health

Keywords: physical activity, adolescents, robust bayesian meta-analysis, risk of bias, grade

DE-PASS best evidence statement (BESt): determinants of adolescents’ device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

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Abstract

Background

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Results

Conclusions

Supplementary Information

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Chinese Journal of School Health

Most cited references 64

The PRISMA 2020 statement: An updated guideline for reporting systematic reviews

Risk‐of‐bias VISualization (robvis): An R package and Shiny web app for visualizing risk‐of‐bias assessments

Global trends in insufficient physical activity among adolescents: a pooled analysis of 298 population-based surveys with 1·6 million participants

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