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
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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
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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)