Level and potential social-ecological factors associated with physical inactivity and sedentary behavior among Moroccan school-age adolescents: a cross-sectional study

Environmental Health and Preventive Medicine, May 2017

Background Creating a successful intervention that supports an active lifestyle and prevents sedentary one requires a better understanding of the factors associated with physical inactivity (PI) and sedentary behavior (SB). However, these factors have not been assessed among Moroccan adolescents. This study aimed to determine prevalence of PI and SB and to explore their potential social-ecological associated factors in school-age adolescents. Methods In this cross-sectional study, 764 students (age range, 14–19 years) were enrolled from six schools in Taza city, Morocco. The Global School-based Student Health Survey was used to collect data about variables. We used bivariate and multivariate analyses to assess relations between dependent and independent variables. Results Overall, the prevalence of PI was 79.5% and SB was 36.5%. Among girls, these rates were higher (87.0 and 39.1%, respectively) than rates shown in boys (70.9 and 33.6%, respectively). In the multivariate logistic regression analysis, PI was associated with the following variables: illiterate father, hunger, suicidal ideation, inadequate vegetable consumption, and absence from physical education classes. Age, inadequate vegetable consumption, and absenteeism were associated with SB. Conclusions The prevalence of PI and SB is high, especially among girls. Thus, there is an urgent need to implement appropriate interventions to reduce PI and SB levels in secondary school-age adolescents and the associated factors identified can be useful.

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Level and potential social-ecological factors associated with physical inactivity and sedentary behavior among Moroccan school-age adolescents: a cross-sectional study

El-ammari et al. Environmental Health and Preventive Medicine Level and potential social-ecological factors associated with physical inactivity and sedentary behavior among Moroccan school-age adolescents: a cross-sectional study Abdelghaffar El-ammari 0 1 Hicham El kazdouh 0 1 Siham Bouftini 0 1 Samira El fakir 0 1 Youness El achhab 0 1 0 Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, University of Sidi Mohamed Ben Abdellah , Fez , Morocco 1 Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy, University of Sidi Mohamed Ben Background: Creating a successful intervention that supports an active lifestyle and prevents sedentary one requires a better understanding of the factors associated with physical inactivity (PI) and sedentary behavior (SB). However, these factors have not been assessed among Moroccan adolescents. This study aimed to determine prevalence of PI and SB and to explore their potential social-ecological associated factors in school-age adolescents. Methods: In this cross-sectional study, 764 students (age range, 14-19 years) were enrolled from six schools in Taza city, Morocco. The Global School-based Student Health Survey was used to collect data about variables. We used bivariate and multivariate analyses to assess relations between dependent and independent variables. Results: Overall, the prevalence of PI was 79.5% and SB was 36.5%. Among girls, these rates were higher (87.0 and 39.1%, respectively) than rates shown in boys (70.9 and 33.6%, respectively). In the multivariate logistic regression analysis, PI was associated with the following variables: illiterate father, hunger, suicidal ideation, inadequate vegetable consumption, and absence from physical education classes. Age, inadequate vegetable consumption, and absenteeism were associated with SB. Conclusions: The prevalence of PI and SB is high, especially among girls. Thus, there is an urgent need to implement appropriate interventions to reduce PI and SB levels in secondary school-age adolescents and the associated factors identified can be useful. Physical inactivity; Sedentary behavior; Adolescents; Associated factors; Morocco - Background Adolescence is a critical stage in human development, during which children undergo hormonal changes and brain maturation and acquire a new set of health-related behaviors that are likely to persist into adulthood [1, 2]. Although most adolescents are perceived as healthy, important risk factors for disease, such as physical inactivity (PI) and sedentary behavior (SB), emerge during this period of life [3, 4]. PI is a global public health concern among adolescents in high-income countries and increasingly in low-and middle-income countries (LMIC) [5]. According to the World Health Organization (WHO), to be healthy, adolescents should accumulate at least 60 min of moderate- to vigorous-intensity physical activity daily [6]. Despite the established health benefits [6, 7], more than 80% of adolescents worldwide do not reach this threshold [6]. SB is another major concern among adolescents and is defined as spending three or more hours per day sitting (excluding time sitting in school or doing homework) [8, 9]. It refers to activities that require low levels of energy expenditure (e.g., sitting, watching TV, and engagement in © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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. other screen-based activities, including driving) [8, 9]. A recent systematic review found that adolescents spend 57% of their time after school in sedentary activities [10]. In our approach, as in many other studies [11–13], PI and SB are regarded as different constructs because they contribute independently to adverse health outcomes [14]. That is, even highly active individuals are susceptible to the negative health effects of excess sedentary activities. Excess PI and SB in adolescents can lead to several negative health outcomes, including increased adiposity, lower fitness, increased cardiometabolic risk, and poor self-esteem [7, 15, 16]. PI can contribute to several noncommunicable diseases such as heart disease, diabetes, and cancer [17]. In 2008, more than 5.3 million of the 57 million deaths that occurred worldwide were attributable to PI. Therefore, interventions to change health behaviors and improve health outcomes should focus on decreasing both PI a (...truncated)


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Abdelghaffar El-ammari, Hicham El kazdouh, Siham Bouftini, Samira El fakir, Youness El achhab. Level and potential social-ecological factors associated with physical inactivity and sedentary behavior among Moroccan school-age adolescents: a cross-sectional study, Environmental Health and Preventive Medicine, 2017, pp. 47, Volume 22, Issue 1, DOI: 10.1186/s12199-017-0657-0