Adolescent religious attendance and spirituality—Are they associated with leisure-time choices?
Adolescent religious attendance and spiritualityÐAre they associated with leisure- time choices?
Klara Malinakova 0 1 2 3 4
Andrea Madarasova Geckova 0 2 3 4
Jitse P. van Dijk 0 1 2 3 4
Michal Kalman 0 2 4
Peter Tavel 0 2 3 4
Sijmen A. Reijneveld 0 1 2 4
0 Agency of the Czech Republic , 15-19968S (https:/ / gacr.cz/) to PT and the Czech Ministry of Education , Youth and Sports (MEYS), LG14042
1 Department of Community and Occupational Medicine, University Medical Center Groningen, University of Groningen , Groningen , The Netherlands , 3 Graduate School Kosice Institute for Society and Health, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic, 4 Department of Health Psychology, Faculty of Medicine, Pavol Jozef Safarik University in Kosice, Kosice, Slovak Republic, 5 Institute of Active Living, Faculty of Physical Culture, Palacky University Olomouc , Olomouc , Czech Republic , 6 Department of Social Medicine and Public Health, Faculty of Medicine and Dentistry, Palacky University Olomouc , Olomouc , Czech Republic
2 Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Data are from the Czech HBSC study whose authors may be contacted at the Institute of Active Lifestyle, Faculty of Physical Culture, Palacky University , Tr. Miru 117, 771 11 Olomouc , Czech Republic
3 Olomouc University Social Health Institute, Palacky University Olomouc , Olomouc , Czech Republic
4 Editor: Mary C. Smith Fawzi, Harvard Medical School , UNITED STATES
Spirituality and religious attendance (RA) have been associated with personal attitudes and
values, and this may affect lifestyle. The aim of this study was to explore their association
with adolescent leisure-time choices in a highly secular environment.
A nationally representative sample of adolescents (n = 4,182, 14.4±1.1 years, 48.6% boys)
participated in the 2014 Health Behaviour in School-aged Children cross-sectional study.
We measured RA, spirituality (adjusted shortened version of the Spiritual Well-Being
Scale), excessive television, computer games, and internet use, as well as participation in
organized leisure-time activities.
Compared to non-attending and non-spiritual respondents, respectively, both attending
respondents and spiritual respondents were less likely to watch television and play
computer games excessively, with odds ratios (ORs) ranging from 0.6 (95% confidence interval
0.5±0.8) to 0.92 (0.9±0.99). Only attending and only spiritual respondents were more likely
to use the internet excessively, but this was not the case for those that were both attending
and spiritual. Moreover, religious and spiritual respondents were more likely to be involved
in at least one organised activity. ORs were 2.9 (1.9±4.3) for RA and 1.3 (1.2±1.4) for
spirituality compared to their counterparts. The same pattern was observed for sporting and
nonand LG 14043. (http://www.msmt.cz/) to MK.
The funders had no role in study design, data
collection and analysis, decision to publish, or
preparation of the manuscript.
Competing interests: The authors have declared
that no competing interests exist.
sporting activities combined (ORs 4.6 (3.0±7.1) and 1.5 (1.4±1.7), respectively) and
regularly reading books or playing a musical instrument.
Adolescent RA and spirituality are associated with a more active way of spending
leisuretime. Further research should focus on understanding potential mechanisms that underlie
Recently, the amount of time spent on screen-based activities (SBA) has emerged as an
important and independent risk factor for the physical and mental health of children and adolescents
]. Excessive amounts of SBA have been shown to be associated with overweight [
unfavourable levels of several cardiovascular risk factors [
] as well as a higher occurrence of
headache and irritability and reports of feeling low and nervous [
]. Some of the content of SBA
seems to add to these risks. For example, playing violent computer games or watching violent
television programs were linked to aggressive thoughts, hostility and less pro-social behaviour
]. Higher levels of screen-based sedentary behaviours have also been linked to other health
damaging behaviours, such as substance use .
A current criterion for excessive adolescent screen-based activity is spending more than
two hours a day on recreational screen time [
], but most adolescents exceed this limit.
Moreover, screen time is growing in North America and Europe [
], including the Czech Republic
]. The fact that sedentary behaviour tracks from childhood into adulthood [
the need to address this issue in adolescence and to support healthier alternatives for
adolescent leisure-time choices.
Organised leisure-time activities (OLTA) are sometimes mentioned as a healthy alternative
for SBA. They have also been associated with other positive outcomes, such as lower substance
], better school performance and attachment to school [
] and better physical and
mental health [
]. Several factors are known to be associated with adolescent participation in
OLTA, such as parental support of the activity, friends, self-efficacy, academic achievement,
psychopathological problems and environmental factors [15±18]. However, it seems that
adolescents themselves associate their involvement in structured leisure activities especially with
their intrinsic motivation [
Religiosity and spirituality could be of special interest in leisure choices, because they are
connected with many dimensions of human life and personal values [
] and also comprise
both an organization of norms and behavioural expectations that can lead to a preference for
certain activities above others . Thus far, this potentially important group of determinants
has not often been studied, and if it has, it has been mostly done in the United States, in which
a significant segment of the population identifies with a religious institution. In contrast, the
Czech Republic is the country with the highest percentage (76.4%) of people that do not have a
religious affliation in the world [
], meaning religion is not a major determinant of main
stream youth culture. This makes it a unique population for research in this field, enabling the
specific effect of religion to be established apart from only that of main stream youth culture.
Therefore, the aim of this study is to assess the relationship between religious attendance
and spirituality (both separately and jointly) and leisure-time choices, specifically SBA and
OLTA, among adolescents in a highly secular environment. For the purpose of this article,
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spirituality is understood as internal individual contentedness, one's perceived closeness to
God and one's sense of meaning of life and of spiritual well-being [
Participants and procedure
We obtained data on a nationally representative sample of Czech boys and girls from the 2014
Health Behaviour in School-aged Children (HBSC) study. This cross-sectional WHO
collaborative study focused on health and health-related behaviour and their socioeconomic
determinants in 11-, 13-, and 15-year-old children. The HBSC study has been conducted at 4-year
intervals since 1983/84 and now includes 44 countries across Europe and North America [
According to the HBSC study protocol, schools were selected randomly after stratification by
region, school size and type of school (primary schools vs. secondary schools). Out of 243
contacted schools 242 schools agreed to participate (response rate 99.6%). Then, classes from the
5th, 7th and 9th grades, in general corresponding to age the categories of 11-, 13- and
15-yearolds, were selected at random, one from each grade per school. Data from 14,539 pupils were
obtained (response rate 89.2%). The majority of non-response was due to illness or other
reasons, e.g. sports or academic competitions (10.6%), and 30 children refused to participate in
the survey (0.2%).
Data were collected between April and June 2014. Questionnaires were distributed by
trained administrators with no teachers present in the classroom in order to reduce response
bias. Respondents had one school lesson (45 minutes) dedicated to completing the
questionnaire. The spirituality questionnaire was offered to only half of the adolescents from the 7th
and 9th grades, so for the purpose of this paper the dataset included 4,889 adolescents who
filled out this section. Of these, 707 were excluded because of incomplete information on age,
gender, spirituality or religious attendance, or because of an age outside of the intended
agebracket, i.e. 12.5 to 16.4 years. This led to a final sample of 4,182 respondents (mean
age = 14.4, SD = 1.1, 48.6% boys).
Participation in the survey was anonymous and voluntary. The Czech HBSC study was
conducted under the auspices of the Ministry of Education, Youth and Sports of the Czech
Republic and the World Health Organization Country Office in the Czech Republic. The study
design was approved by the Ethics Committee of the Faculty of Physical Culture, Palacky
University in Olomouc (No. 17/2013), and conducted in accordance with the ethical requirements
formulated by the Convention on Human Rights and Biomedicine (40/2000 Coll.). Other
information regarding the ethical issues connected with this study can be found in the study of
Badura, Sigmund [
], which dealt with the same primary data.
Religious attendance was measured as the frequency of attending church or religious sessions
using the question: ªHow often do you go to church or to religious sessions?º Possible answers
were: several times a week; approximately once a week; approximately once a month; a few
times a year; or never. Those who reported attending religious sessions at least once a week
were considered attending.
Spirituality was measured using the adjusted shortened version of the Spiritual Well-Being
Scale (SWBS) [
] measuring overall spiritual well-being. Response possibilities for all seven
items regarded a 6-point scale that ranged from `strongly agree' (1) to `strongly disagree' (6),
leading to scores from 7 to 42. A higher score represented greater spiritual well-being. In the
analyses, spirituality was used as a continuous variable, but for the purpose of dichotomisation
for sensitivity analysis, participants with a score of 34 or higher (the upper quartile of the
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scores) were considered as spiritual, and the rest as non-spiritual. Cronbach's alpha was 0.81
in our sample.
SBA was assessed using three variables: excessive use of television, the internet, and
computer games. Excessive television use was assessed by the question: ªAbout how many hours a
day do you usually watch television (including YouTube and similar pages), a DVD or similar
programs on a screen in your free time?º with nine response categories ranging from `I do not
watch at all' to `About seven or more hours a day'. Following the HBSC dichotomisation [
watching television for two or more hours per day on weekdays was classified as excessive.
Excessive playing of computer games was measured with the question: ªAbout how many
hours a day do you usually play games on a computer, games console, tablet (e.g. iPad),
smartphone or other electronic device (do not count physical fitness games) in your free time?º with
nine response categories ranging from `not at all' to `about seven or more hours a day'.
Following the HBSC dichotomisation [
], playing computer games two or more hours on weekdays
was classified as excessive.
Excessive internet use was measured with the Excessive Internet Use scale [
assesses the frequency of five behaviour symptoms of excessive internet use (ªI felt
uncomfortable when I could not be on the internet.º; ªI found myself surfing the internet, even though I
did not enjoy it.º; ªI neglected my family, friends, school work or hobbies because of the time
spent on the internet.º; ªI tried to reduce the time spent on the internet, but without success.º),
with responses being: Very often / Often / Sometimes / Almost never. `Often' and `Very often'
in any of the items were classified as using the internet excessively.
Participation in organized leisure-time activities (OLTA) was assessed by the question: ªIn
your free time, do you do any of these organized activities?º with the explanation: ªWe mean
activities you do in sports or other clubs or organizationsº followed by six items dealing with
different types of leisure-time activities (team sports, individual sports, art school, youth
organizations, activities in leisure-time centres and church meetings or singing), including
country-specific examples. The possible answers were `Yes' or `No'. For the purpose of a more
detailed analysis, the respondents clustered as follows: 1) Not active (not involved in a sporting
or a non-sporting activity); 2) Active only in sports; 3) Active only in non-sporting activity; 4)
Active in both sporting and non-sporting activity.
Moderate-to-vigoro us physical activity (MVPA) was measured with the question: ªOver the
past 7 days, on how many days were you physically active for total of at least 60 minutes per
day?ºwith the introductory instruction: ªPhysical activity is any activity that increases your
heart rate and makes you get out of breath some of the timeª, which was followed by a few
examples of possible kinds of physical activity. According to the WHO recommendation [
the participants who reported being physically active 7 days in a week were considered as
having a sufficient MVPA while the remaining participants as not having a sufficient MVPA.
Additional leisure time activities were assessed by the question: ªIn your free time, how
often do you devote yourself to the following activities?ºfollowed by the concrete specifications
of the activities (reading books, playing a musical instrument, creative activities) with five
response categories ranging from `Daily' to `Never'. `Daily' and `A few times a week' were
classified as practicing the activity regularly, with the rest classified as non-regular.
The socioeconomic status of the respondents' families was used as a covariate and was
assessed by The Family Affluence Scale (FAS) [
]. The scale examines the number of cars
owned by the family, having one's own bedroom, number of computers in the household,
number of family holidays outside of the country, number of bathrooms, and dishwasher
ownership. The summary score ranges from 10 to 13 and following HBSC recommendations it was
converted into a fractional rank (ridit) score, leading to transformation of ordinal data to an
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interval scale with a normalised range (from 0 to 1, with higher score indicating higher
socioeconomic position) and distribution.
Perceived family support was used as a covariate and was measured using the
Multidimensional Scale of Perceived Social Support (MSPSS) family subscale [
], which is assessed with
four items. Response options ranged from 1 (very strongly disagree) to 7 (very strongly agree).
For the purpose of the analysis, a mean MSPSS score was used.
First, we described the background characteristics of the sample. We then assessed the
associations of religious attendance (Model 1) and spirituality standardized to z-scores (Model
2) separately, their combination (Model 3) and their interaction (Model 4) with three types
of screen-based activities using a binary logistic regression model adjusted for gender, age,
socioeconomic status and perceived family support. Each of the independent variables was
assessed in a separate model. In the same way we assessed the associations of religious
attendance and religiosity with the OLTA; first the associations with the binary overall OLTA
variable (at least one activity vs. inactive) using a binary logistic model were assessed, and
next the associations with the various OLTA clusters were examined using a multinomial
logistic regression model. In the last step we used a binary logistic model to assess the
associations of religious attendance and spirituality with the selected additional leisure time
We repeated the analyses with spirituality as dichotomised instead of as a continuous
variable, leading to similar results. Therefore, we used the dichotomised variable for the graphical
representation of the associations with screen-based activities and OLTA. In the tables,
however, we present only the results of analyses with the continuous variable. All analyses were
performed using the statistical software package IBM SPSS version 21.
Description of the population
The background characteristics of the sample are presented in Table 1. Of the respondents, as
measured here, 7.1% were religiously attending, and 9.1% were spiritual, i.e. scored in the
highest quartile of the spirituality scale. Religious attendance and spirituality were moderately
correlated (r = 0.4).
Table 2 shows the associations of screen-based activities with religious attendance and
spirituality. Both attending (Model 1) participants and spiritual (Model 2) participants were less likely
to report excessive use of television and computer games. Moreover, in the case of excessive
playing of computer games, a significant interaction showed that religious attendance
reinforced the association of spirituality with this behaviour. We found no significant associations
of excessive internet use with religious attendance or spirituality separately, or in their
combination (Model 3). However, their interaction (Model 4) was associated with a significantly
lower likelihood of excessive internet use among participants who were both attending and
spiritual (or non-attending/non-spiritual) compared with those who either only attended or
were more spiritual. For a graphical representation of sensitivity analysis of the interaction
using the dichotomised spirituality variable, see Fig 1.
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Organised leisure-time activities (OLTA)
Most adolescents were involved in at least one of the six types of organized activities, the
average number of activities being 1.3 (SD = 1.1) in the total sample. Attending respondents
participated on average in 2.3 (SD = 1.3) different activities, while non-attending in 1.3 (SD = 1.0)
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aAll the associations were adjusted for age, gender, socioeconomic status (FAS) and family support (mean MSPSS).
bSpirituality (per SD) = spirituality score standardized to z-scores
(p<0.001). The rate of participation of attending respondents was higher in all observed
nonsporting activities (p<0.001). Regarding participation in sporting activities, no significant
differences were observed among the groups.
The results of binary logistic regression using the dichotomised overall OLTA variable
showed that both attending respondents and spiritual respondents were more likely to be
involved in at least one OLTA, with OR = 2.9 (1.9±4.3) for religious attendance and OR = 1.3
(1.2±1.4) for spirituality (p<0.001). There were no statistically significant interactions of
religious attendance and spirituality. See Fig 2 for a graphical representation.
Fig 1. Frequency of adolescent excessive television use, excessive computer games playing and excessive internet use with dichotomised spirituality and religious
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Fig 2. Associations of adolescent OLTA clusters with dichotomised spirituality and religious attendance.
We next performed multinomial logistic regression analyses with the inactive cluster being
the reference category (Table 3), which showed that both attending and being spiritual tended
to have more non-sporting activities or a mixture of both sporting and other activities (Fig 2).
The attending respondents were approximately two-times less likely to be involved exclusively
in sporting activities, but they did not differ significantly regarding general participation in
such activities (not shown).
Additional leisure-time activities
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level of spirituality were more likely to have sufficient physical activity. Regression model was
not significant in the case of regular art activities. Similarly, the interaction effect was not
significant for any of these variables.
We found that religious attendance and spirituality separately were associated with a lower
prevalence of excessive television use. The same held for excessive playing of computer games,
where in addition, religious attendance reinforced the protective effect of spirituality.
Regarding excessive internet use, respondents who were either only attending or only spiritual were
more likely to use the internet excessively. However, the combination of attending religious
activities and being spiritual was protective with respect to excessive internet use.
We further found that attending respondents, as well as spiritual respondents, were more
likely to be involved in at least one activity and tended to have a greater variety of OLTA (a
combination of sporting and non-sporting activities). They were also more likely to regularly
read books and to play a musical instrument. Spirituality was also associated with higher
chances of having sufficient physical activity.
We found that both attending respondents and spiritual respondents were less likely to
watch television or play computer games excessively, while religiosity and spirituality did not
show any significant association with excessive internet use unless they were in interaction.
The limited evidence on religiosity and television viewing has yielded contrasting findings [
], and this also holds for excessive internet use [
]. However, recent students among
adolescents observed that religious and spiritual youths watched less television and played
fewer video games [35±37], which corresponds with our findings. One of the possible
explanations regarding our results could be that in families with high religiosity/spirituality parents
tend to keep more oversight of adolescent behaviour [38±40]. This may promote
internalisation of adult behavioural norms [
]. Thus the parents' attitudes and behaviour can be a
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model that shapes adolescent leisure choices. Some parents put a higher emphasis on the
positive developmental outcomes of leisure activities [
]. Unstructured activities such as
television viewing and playing computer games may be seen as less desirable within families that
regularly attend religious activities if the content does not reflect the same or similar value
In our study we observed that attending as well as spiritual respondents were more likely to
participate in at least one OLTA, and they tended to participate in a greater variety of activities.
In addition, when considering sporting versus non-sporting activities, they were less likely to
be involved solely in sports. Moreover, they were more likely to regularly read books and to
play a musical instrument. Spirituality was also associated with higher chances of having
sufficient physical activity. There are several possible explanations for these results. First,
approximately half of the religious and one-third of the spiritual respondents reported being engaged
in some kind of church activity, which itself elevated the number of attended activities. Second,
given that care for children and their development is seen as a relatively important value in
religious families [
], attending various activities as well as reading or playing a musical
instrument may be supported by parents who see these activities as promoting child
development. Third, within the local religious community, different activities are often offered,
including sports [
]. Attending adolescents might be therefore more likely to get a multiple offer of
activities of various kinds, which could also explain their lower exclusive involvement in
sports. Fourth, religious programs can serve as a natural platform for the development of
], and peers who are already involved in some activity may represent another
motivation for participation in OLTA [
]. Moreover, religious congregations also represent
places where adolescents can make significant encouraging contact with other adults [
which may attract them to some activities. It is therefore possible that religious attendance and
sprituality may promote involvement in organised activities via several routes of community
We further found that respondents who were both attending and spiritual were less likely
to use the internet excessively. Moreover, a sensitive analysis with dichotomised spirituality
revealed that in contrast respondents who were either only attending or only spiritual more
likely to use the internet excessively. This suggests that in our population the respondents who
did not have problem with internet overuse were either both attending and spiritual or they
were neither of these. An association with an escape motive is commonly mentioned in the
case of excessive internet use [
]. Therefore, it is possible that a combination of religious
attendance and spirituality could serve as a coping resource which, together with higher social
support, could lower the need for escape into a virtual world [
]. At the same time, some
research shows that the inconsistency in religiosity and spirituality levels is associated with a
higher vulnerability to mental disorders or problematic behaviour [
], which is in line
with our results. Moreover, non-attending spiritual participants could be less likely to benefit
from social support connected with an organised religion. Therefore, further analyses of
separate as well as combined effects of religious attendance and spirituality and different aspects of
human behaviour could help us to understand better the underlying mechanisms.
Strengths and limitations of this study
This study has several important strengths, the most important being the large and
representative sample size of adolescents, the high response rate and the use of the well-established HBSC
methodology. A limitation is the relatively small number of attending respondents, which may
have affected our power to detect differences despite our large sample. However, this
sub-sample still included 296 respondents. Another limitation might be our use of adolescent
self10 / 14
report, which can be inaccurate or influenced by social desirability. Given the prevailing
secular attitude within the country, this may have led to some underreporting of RA and
spirituality, and thus some underestimating of the associations. Regarding SBA, validation studies [
did not show the tendency to overestimate or underestimate daily amounts. A last limitation is
the cross-sectional design of the study, which does not allow us to make conclusions on
Our findings reveal that adolescent religious attendance and spirituality are associated with
their leisure-time choices. This suggests that future studies should focus on understanding the
direction and potential pathways for these relationships. Consequently, it could assess whether
educational programs for adolescents aimed at fostering spiritual values could help lower the
occurrence of undesirable behaviours.
To the best of our knowledge, this is the first study examining the associations of SBA, OLTA
and adolescent religious attendance and spirituality. We found that both attending
respondents and spiritual respondents were less likely to watch television or play computer games
excessively. Respondents who were either only attending or only spiritual were more likely to
use the internet excessively. However, the combination of attending religious activities and
being spiritual was protective with respect to excessive internet use. These respondents were
further more likely to be involved in organized activities, tended to participate in a greater
variety of them and were more likely to regularly read books and to play a musical instrument.
Spirituality was also associated with higher chances of having sufficient physical activity. This
suggests that increasing secularisation might lead to further unfavourable changes in
adolescent SBA and OLTA.
S1 Database. Adolescent religious attendance and spiritualityÐAre they associated with
This study was supported by the Grant Agency of the Czech Republic, project Spirituality and
Health among Adolescents and Adults in the Czech Republic (15-19968S) and by the Czech
Ministry of Education, Youth and Sports (MEYS) under Contracts No. LG14042 and No. LG
Conceptualization: Klara Malinakova, Andrea Madarasova Geckova, Jitse P. van Dijk, Peter
Data curation: Michal Kalman.
Formal analysis: Klara Malinakova, Andrea Madarasova Geckova, Sijmen A. Reijneveld.
Funding acquisition: Michal Kalman.
Methodology: Jitse P. van Dijk, Peter Tavel.
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Project administration: Michal Kalman, Peter Tavel.
Supervision: Peter Tavel.
Validation: Andrea Madarasova Geckova, Sijmen A. Reijneveld.
Visualization: Klara Malinakova.
Writing ± original draft: Klara Malinakova.
Writing ± review & editing: Andrea Madarasova Geckova, Jitse P. van Dijk, Michal Kalman,
Peter Tavel, Sijmen A. Reijneveld.
12 / 14
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