Adolescent Physical Activity Differences
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Running Head: PHYSICAL ACTIVITY GENDER DIFFERENCES
Physical Activity Rates among 18-24 years:
Assessing Gender Differences
Abstract
There is copious research outlining the significance of adequate levels of physical activity and how it relates to healthy, active lifestyles; however the literature suggests that there are gender differences related to physical activity (PA) rates. The purpose of the study is to assess physical activity differences in 18-24 year olds, and the need for gender specific interventions that promote PA. Using the National Health Information Survey data sub-set of 18-24 year olds that meet the Physical Activity Guidelines, analysis was conducted to determine if male and females differ in their activity levels. This data was collected from 75,000-100,000 individuals 18 years and over, from all US states. The results gleaned from tests, clearly identified statistical differences between genders in terms of activity levels, wherein females were much less active than their male counterparts. Additional research and evaluation of interventions that encourage PA rates among females is needed to address this issue in effort to prevent future chronic diseases by producing long-term health benefits.
Physical Activity Rates among 18-24 years:
Assessing Gender Differences
Introduction
Physical activity refers to when the body uses energy in the form of movement or exercise (USDHHS, 2008). It is well recognized that regular physical activity can help to prevent chronic diseases and produce long-term health benefits (CDC, 2011; USDHHS, 2008). In 2008, the United States Department of Human and Health Services released Physical Activity Guidelines (PAGs) that provide information on the amounts and types of activity that is needed to provide health benefits for adults 18 – 65 years of age (USDHHS, 2008). Scientific evidence has shown that the levels of physical activity among American young adults (aged 18-24 years) have been consistently poor since 1998 (CDC, 1998-2009). About 25% of American young adults are not meeting the recommended PAGs (CDC, 2007-2009). In particular evidence reveals that within this age group, females are significantly less active than their male counterparts (33.0% of males and 17.6% of females) (CDC, 2007-2009). These statistics are disturbing as poor physical activity rates may attribute to several adverse health outcomes, such as cardiovascular disease, type 2 diabetes, metabolic syndrome, and some cancers (CDC, 2011; USDHHS, 2008).
The Department of Human and Health Services recognized the potential impact of these frightening statistics, and have made a concerted effort to address these concerns. As such, one of the Healthy People 2020 objectives is to "Increase the proportion of adults who meet current Federal physical activity guidelines for aerobic physical activity and for muscle-strengthening activity" (USDHHS, 2012). While this objective is greatly needed, additional focus on young, female adults is necessary. Opportunities for activity for females in that age group are often competitive in nature. Programs that offer non-competitive activities in a non-intimidating environment are crucial for sustained, lifelong involvement in physical activity (Wikkerink, 2005).
Purpose of the study
The purpose of the study is to statistically assess physical activity gender differences in young adults between the ages of 18-24 years. Furthermore, if gender if differences are apparent, is there a need for gender specific interventions to address the differences in physical activity rates among this age group.
Significance of the study
There is copious research regarding the significance of the level of physical activity in children and how it relates to healthy, active lifestyles in adulthood (CDC, 2011; FSSS, 2012). This is especially concerning for females, recognizing that their rates of activity are far less than their male counterparts (WHO, 2004). There is evidence that suggests gender differences related to sport and physical activity opportunities can influence participation (WHO, 2004). If females do not partake in these activities, they cannot benefit from positive health and social effects including in later life (WHO, 2004). In fact, engaging in an active lifestyle, by being physically active for about seven hours per week can reduce the risk of early mortality by 40 percent, than those who are active less than 30 minutes on a weekly basis (CDC, 2011). More research needs to be done to better understand the how this can impact females.
Intervention studies that provide females aged 18-24 with free non-competitive opportunities for physical activity may provide hope to address these dismal activity rates, and influence this target population to maintain a healthy, active lifestyle throughout their adult years. This has potential to reduce the risk of preventable chronic diseases that may plague their later years.
Data set
The data source used for this research manuscript will be extracted from the National Health Interview Survey (NHIS), which is located on the interactive health data website, hosted by the Centers for Disease Control (CDC) (CDC, 1998-2009). For the purpose of this research, we will focus on the data sub-set for 18-24 year old females from 2007-2009. This data uses three-year averages to ensure firm estimates (CDC, 1998-2009). This data is collected through household interviews. The questions asked to the respondents correspond with the PAGs, and serve as an indicator for the Healthy People 2020 physical activity objective.
Literature Review
Over the past several decades, scientific evidence has shown that the levels of physical activity (PA) and fitness of female youth have declined markedly amongst this population, leading to insufficient PA levels (Okely et al., 2011). This literature review will serve as a synopsis of the importance of this issue in adolescent and young adult females. The studies associated with this review highlight the consequences of physical inactivity (PI), potential barriers and motivators associated with PA, interventions, as well as limitations of the literature.
Consequences of physical inactivity
Physical inactivity is one of the leading modifiable risk factors attributing to premature morbidity and mortality (Budd & Volpe, 2006; Okely et al., 2011). The issue of PI among youth is particularly alarming, as they will not obtain the health benefits associated with regular PA. Although research shows that youth are generally not meeting the PA guidelines of 60 minutes of moderate-to-vigorous physical activity (MVPA) on a daily basis, evidence reveals that girls are significantly less active than their male counterparts (Dishman et al., 2004; Okely et al., 2011). Research also suggests that girls are becoming less active as they grow and this continues into adulthood, putting females at risk of acquiring chronic diseases, such as type 2 diabetes, obesity, heart disease, and certain types of cancers (Ward et al., 2011; Craig, 2001). Inactivity is also associated with poorer self-esteem, anxiety and depression (Ward et al., 2011; Annesi, 2005). Youth who are physically active, are less likely to smoke, consume alcohol, use marijuana, or engage in sexual risk behaviors when compared to inactive peers (Kulig, Brener and McManus, 2003; Tur, Puig, Pons, and Benito, 2003). Physical activity has the potential to increase academic performance in terms of memory and observation, and significantly improves attitude, concentration, discipline, and behavior in the classroom (Ratey, 2008; Ward et al., 2011).
Potential barriers related to physical activity participation
Several research studies noted perceived barriers to physical activity. This information was garnered through questionnaires. Dudley, Okely, Pearson and Peat (2009) highlight some of the major barriers that confront adolescent girls, based on the youth surveys include feeling that they have no input in activities and programming, lack of teacher support and attitudes, not being aware of the purpose for PA. These findings are consistent with research conducted by Neumark-Sztainer, Story, Hannan, Tharp and Rex (2003). In addition to a lack of teacher support as a barrier, they also noted that a lack of support from parents and peers was a strong factor associated with lower PA levels. In addition, several studies with youth and parental data note that perceived time constraints is a significant barrier for PA (Neumark-Sztainer, Story, Hannan, Tharp and Rex, 2003; Ward et al., 2011; Eime, Payne, Casey & Harvey, 2010). In another study, Eime, Payne, Casey and Harvey (2008) examined the transition in participation in sport and unstructured PA in girls living in rural areas. Within this randomized, qualitative study, they also recognized that perceived time constraints related to organized sports was due to their desire to do well academically. They prioritized education over team sports, and favored individual activities (Eime, Payne, Casey & Harvey, 2008).
Motivators for physical activity participation in adolescent girls
Understanding why girls participate in physical activity and what motivates them to be involved and stay involved is an important aspect to consider when designing a physical activity program for females. Not surprisingly, after understanding potential barriers to physical activity, it would stand to reason; the inverse would provide positive support resulting in motivation for PA engagement.
The evaluation of the ‘My Parenting SOS’ study, which measured PA using an accelerometer, and 24 hour recall focused on a family approach to help reduce the risk of obesity; they concluded that parental role modeling is a positive influence for physical activity in children and youth (Ward et al., 2011). This research is consistent with the findings of a study by Bauer, Neumark-Sztainer, Fulkerson, Hannon and Story (2011). Within this study, the researchers looked at familial correlates of female youth physical activity, and other variables. In this cross-sectional design, they found positive associations with family support/role modeling and MVPA (Bauer, Neumark-Sztainer, Fulkerson, Hannon & Story, 2011).
Sallis et al. (2001) studied the association of school environments with youth activity. Researchers investigated 137 locations at 24 middle schools to examine if the characteristics of the school environment, such as basketball courts, gymnasiums, and open field space had an impact on physical activity (Sallis et al., 2001). They found that schools with physical infrastructure improvements and high levels of supervision led to higher PA rates. Dudley, Okely, Pearson and Peat (2010) conducted a randomized controlled trial that echoed similar motivators for PA. They noted that coaches and teaching staff could provide motivation and incentive for students to participate in PA. They also stated that the teaching staff should be adequately trained and knowledgeable about various types of activities (Dudley, Okely, Pearson and Peat, 2010). Teacher participation was also noted as a motivator for PA. Okely et al (2011), conclude that the inclusion and role-modeling of teachers was positively associated with PA engagement in youth. This also included how school curriculum planning should ensure that PA is incorporated into classes and the school culture in general (Budd & Volpe, 2006; Okely, 2011).
Peer support can also help motivate PA participation among female youth. In a study that examined the views of girls pertaining to PA and sport participation using self-reported data, researchers noted that the girls enjoyed sport and activities for the social interactions (Eime, Payne, Casey & Harvey, 2008). The research of Okely et al. (2011), echoed similar findings where they assessed social support using a 5-point Likert scale for PA and school support, indicated a positive association with social support and activity. It was also noted that there was reduced stigma associated with their involvement in the intervention, as all girls were included (Okely et al., 2011). Females enjoy being active with their friends and are more likely to be reach the daily recommended physical activity levels if they have an active friend to participate with.
The research was very clear about the need to offer alternatives to competitive sports during adolescence for females, preferably without cost. Dudley, Okely, Pearson and Peat (2010) conducted a randomized control trial that examined a pilot that engaged adolescent girls from linguistically diverse and low income backgrounds in school sport. They reported several ways to improved participation and increased the enjoyment of physical activity when there was more focus on recreational activities as opposed to activities that were competitive in nature. They also noted that the incorporation of music and sharing the decision making and planning of activities motivated the female youth to participate in PA opportunities (Dudley, Okely, Pearson and Peat, 2010). The ‘Girls in Sport’ randomized controlled trial conducted by Okely et al. (2011) shared these same findings. Programs that offer non-competitive activities in a non-intimidating environment are important for sustained involvement in PA.
Interventions
The Lifestyle Education for Activity Program (LEAP) is a school based program for adolescent girls that emphasize curricula changes as mediators for change for PA (Dishman et al., 2004). In this study, the researchers evaluated the effects of the LEAP program using 24 paired, and randomized high schools. The results of this study provide encouraging results that the use of self-efficacy as an intervention can increase PA in adolescent girls (Dishman et al., 2004).
Okely et al. (2011) designed a randomized control trial to examine a school based intervention that aimed to promote and/or maintain MVPA among adolescent girls with a mean age of 13.6 years. The researchers did not find statistically significant differences between the control and intervention group which consisted of 24 matched schools; 12 control and 12 intervention schools (771 intervention and 747 control participants). They were able to obtain accelerometer data from 79% of the participants (n=1199), which revealed that the sample spent less than 5% of their awake daily hours engaged in MVPA. Furthermore, this data also revealed that the adolescent girls in this study were sedentary for 60% of their waking hours. However, using questionnaires to identify other outcomes measures (e.g. self-worth, confidence, social support, and environment), the researchers were able to better understand motivators and facilitators as previously discussed for PA within a school setting, including using a community based participatory research approach that brought about changes in school environment, healthy school policy, and curriculum changes (Okely et al., 2011).
Limitations of research/literature
One limitation of the research is when evaluators use surveys and questionnaires to identify PA behaviors and associated information. Physical activity surveys that require feedback related to estimates of time spent in physical activity are based on subjective reporting. In looking at the absolute measures of time spent in physical activity, there is a risk that respondents may overestimate their participation in PA. This is not uncommon as other studies have also shown an overestimation of physical activity when comparing subjective survey measures to direct measures, such as accelerometry. One study comparing direct versus subjective measures of physical activity among youth found that youth overestimated their physical activity by 48 minutes when compared to physical activity as measured by accelerometer (Sallis et al., 1996). In a research article by Rangul, Holmen, Kurtze, Cuypers and Midthjell (2008), they investigated the reliability and validity of two frequently used self-adminstered PA questionnaires for youth, specifically the International Physical Activity Questionnaire (IPAQ) and the World Health Organization’s Health Behavior in School Children (HBSC) questionnaire. They compare answers with fitness testing, PA level (PAL), and the measurement of total energy expenditure (TEE). They found that both self reported and administered surveys showed a low correlation with the physical measurement of PAL and TEE (Rangul, Holmen, Kurtze, Cuypers & Midthjell, 2008). Future researchers should consider the reliability and validity of self-administered PA questionnaires, and consider other direct measures of PA that can be used.