Journal of Physical Activity and Health, 2015, 12, 253 -256 http://dx.doi.org/10.1123/jpah.2013-0228 © 2015 Human Kinetics, Inc.
Official Journal of ISPAH www.JPAH-Journal.com ORIGINAL RESEARCH
Do Students Know the Physical Activity Recommendations for Health Promotion? Adilson Marques, João Martins, Hugo Sarmento, Leonardo Rocha, and Francisco Carreiro da Costa Background: Knowledge is required for people to make health decisions. It can be conjectured that knowledge of physical activity recommended levels can be a step to behavior change. This study examined the knowledge of physical activity guidelines of adolescents who were completing the secondary school. Methods: A survey was conducted with 2718 students (1613 girls), aged 16 to 18 years (Mean = 17.2 ± 0.2 years). Gender and age were self-reported and socioeconomic status was calculated based on parental occupation. Students were asked about frequency, duration, and intensity of physical activity to achieve the recommended level. Chi-square was applied to the results. Results: 16.2% reported that physical activity should be practiced daily. For the duration component of the recommendation, 43.5% identified correctly that the minimum recommended is 60 min/day. The intensity component was correctly answered by 62.7%. Considering all the components of the recommendation, only 3.6% of the students were able to identify correctly the physical activity recommendation, with no differences between genders or among socioeconomic status. Conclusions: These results highlight the need for an effective communication strategy for disseminating the message to ensure that young people are aware of, and understand the physical activity guidelines. Keywords: adolescent, gender, guidelines and recommendations Models of communication and changing behaviors suggest that knowledge about a behavior plays a significant role in persuading people to change their behaviors.1 According to Social Learning Theory, knowledge is required for people to make health decisions.2 Therefore, it can be conjectured that knowledge of guidance for physical activity can be a step to behavior change, with respect to adopting and/or maintaining an active lifestyle. Studies have supported this assumption, showing that knowledge of healthrelated physical activity is linked with increasing physical activity among children, adolescents, and youth.3–6 The result of these studies highlights the importance of education in delivering the physical activity recommendation message, especially among young people. Several national and international organizations have recommended that young people should engage in at least 60 minutes or more of moderate-to-vigorous physical activity (MVPA) every day.7–9 The amount of time recommended can be accumulated in bouts of at least 10 minutes, in appropriate forms, for the motor development of young people. These recommendations are generally applicable for all children, adolescents, and youth regardless of gender and socioeconomic status (SES).9 Marques (
[email protected]) and da Costa are with the Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; da Costa is also with the Faculty of Physical Education and Sport, Lusophone University of Humanities and Technologies, Lisbon, Portugal. Martins is with the Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal; and the Faculty of Physical Education and Sport, Lusophone University of Humanities and Technologies, Lisbon, Portugal. Sarmento is with the Maia Institute of Higher Education, Maia, Portugal; and the Superior School of Education, Polytechnic Institute of Viseu, Viseu, Portugal. Rocha is with the Faculty of Physical Education and Sport, Lusophone University of Humanities and Technologies, Lisbon, Portugal.
In Portugal and throughout Europe, this recommendation has been emphasized in numerous documents10–13 and it is expected that young people are aware of the importance of physical activity and the frequency, duration and intensity in which they should engage. For this, Physical Education is important in delivering the message to the school-age people. The Portuguese National Curriculum for Physical Education was revised and among its goals is the notion that students have to acquire knowledge of health-related physical activity and the amount they have to practice to benefit their health.14 Knowing how much physical activity young people should do to benefit their health could be a potential facilitator. Thus, the objective of this paper was to examine the knowledge of physical activity guidelines of adolescents who were completing the final grade of secondary school. Considering the low levels of physical activity in Portuguese young people,15 we hypothesized that students do not have an accurate knowledge of the physical activity recommendation. To our knowledge, this is the first study in Portugal that assessed the knowledge of physical activity recommendations, among young people. This is particularly important because the sample consisted of students who were finishing secondary school (grade 12), after having Physical Education from at least grade 5. Understanding levels of accurate knowledge might help in the development of more effective campaigns and messages to promote physical activity.
Methods Participants Data were collected as part of an on-going study that has been assessing physical activity and health-related knowledge among young people. This study involved a representative sample of Portuguese high school students who were completing the 12th grade. Data were collected taking into account the location, number of students by age and gender from 31 randomly selected schools in 253
254 Marques et al
the Portuguese regions (Norte, Lisboa, Algarve, and Madeira). The autonomous regions of Azores were not included in the study. Of the 3465 students enrolled in grade 12 at the schools, 2979 completed the survey (a response rate of 86%). Of these 2979, 17 had missing data for gender, 244 were more than 18 years old, and were dropped from the analysis. The final sample was 2718 (1105 boys, 1613 girls) aged 16 to 18 years (17.2 ± 0.2). The study was approved by the institutional review boards at the author’s institutions.
Procedure
Instruments
Data Analysis
The students were asked 3 questions to identify the minimum recommended amount of physical activity for overall health benefits. First, they were presented with a frequency item: “How many days a week of physical activity are recommended for overall health benefits?” A 7-point response scale was provided, ranging from 1 (1 day) to 7 (every day); 7 (every day) was the accurate answer. Adolescents were then asked a duration item: “On those days, how long should adolescents be physically active to stay healthy?” Seven response options were provided, ranging from 1 (≥ 15 min/ day) to 7 (≥ 105 min/day); 4 (≥ 60 min/day) was the accurate answer. Finally, students were asked to report the intensity: “When practicing physical activity what is the recommended intensity to maintain or improve health?” They had 4 response options: light, moderate, vigorous, moderate-to-vigorous; moderate-to-vigorous was the accurate answer. Based on the 3 questions of the physical activity recommendation (frequency, duration, and intensity) we computed a new variable. Those who responded accurately on the 3 questions were considered as knowledgeable of the recommendation for physical activity, and those who did not respond accurately on the 3 questions were considered that did not know the recommendation. Gender and age were self-reported. Socioeconomic status (SES) was calculated based on parental occupation. Parents’ occupation titles were regrouped to classify the subjects as lower, middle, and upper class. The lower class included skilled and unskilled manual workers, farmers, and fishermen; the middle class included service occupations such as nonprofessional health service workers, office clerks, and salespeople; the upper class consisted of business-owners, executives, university-educated specialists, and professionals.16
Descriptive statistics were calculated for the entire sample and according to gender and SES. The chi-square (χ2) was used to determine the differences between awareness of physical activity recommendation, and gender and SES. The analysis was conducted with SPSS 20.0. The level of significance was set at P < .05.
To do this study an authorization was requested from the principal of each school. Before completing the questionnaire written informed consent was obtained from each student and their legal guardian. The questionnaire was administrated by physical education teachers in class time, during the spring of 2011 and 2012, and completed anonymously.
Results Descriptive characteristics of the sample are displayed in Table 1. Briefly, most participants were 17 years old (96.4%), and there were more girls than boys. Students from the middle class amounted to 38.9%, followed by 32% from the lower SES, and 29% from the upper class. Table 2 displays the recorded answers for the physical activity recommendation. Only 16.2% accurately reported that physical activity should be practiced every day, and 4.2% did not know the answer. There were not significant differences between gender (P = .533), and among the different SES groups (P = .050). However, girls and those from the lower SES had a higher rate of correct responses. For the duration component of the recommendation, 43.5% identified correctly that the minimum recommended is 60 minutes a day. The correct answered rate was significantly higher among boys (P = .003), and among those from the higher SES (P < .001). The intensity component was correctly answered by the most of students (62.7%). A higher correct response rate was obtained by girls (P = .001), and students from the low SES (P = .016). Finally, considering all the components of the recommendation together, only 3.6% were able to identify correctly the physical activity recommendation for young people, with no differences between genders or among SES.
Table 1 Demographic Characteristics of the Study Sample (n = 2718); Portugal, 2011–2012 Variable Gender Boys Girls Age 16 years 17 years 18 years SES Low Middle High
n
%
1105 1613
40.7 59.3
30 2619 69
1.1 96.4 2.5
871 1058 789
32.0 38.9 29.0
Abbreviations: SES, socioeconomic status. Note. Data are presented as frequencies and percentages.
Knowledge of Physical Activity Recommendation 255
Table 2 Students’ Answers of the Components of Physical Activity Recommendation for Young People; Portugal, 2011–2012 Variable Frequency Do not know Know Duration Do not know Know Intensity Do not know Know Knowledge of guidelines Do not know Know
Boys
Gender Girls
932 (84.3) 173 (15.7)
1356 (83.4) 267 (16.6)
587 (53.1) 518 (46.9)
950 (58.9) 663 (41.1)
455 (41.2) 650 (58.8)
559 (34.7) 1054 (65.3)
1065 (96.4) 40 (3.6)
1555 (96.4) 58 (3.6)
P 0.533
Low
SES Middle
High
711 (81.6) 160 (18.4)
888 (83.9) 170 (16.1)
679 (86.1) 110 (13.9)
533 (61.2) 338 (38.8)
610 (57.7) 448 (43.3)
394 (49.9) 395 (50.1)
292 (35.5) 579 (66.5)
420 (39.7) 638 (60.3)
302 (38.3) 487 (61.7)
832 (95.5) 39 (4.5)
1023 (96.7) 35 (3.3)
765 (97.0) 24 (3.0)
0.003
P 0.050
Total 2278 (83.8) 440 (16.2)
