Inequalities in physical activity

Background Eighty one percent of adolescents do not meet the recommended physical activity (PA) guidelines with levels of physical inactivity declining steadily with age and more pronounced in girls of low socioeconomic position (SEP). Furthermore, early adolescence is a time when the rate of decline in PA is most severe amongst girls, placing them at an increased likelihood of developing negative health outcomes associated with physical inactivity. Purpose In response, the aim of this study was to explore low-SEP pre-teen girls’ experiences of being physically active and to understand their perceptions of the individual, social and environmental factors that influence these experiences. Methods Focus groups were conducted with 107 girls aged 10 – 12 years from four urban and three rural primary schools. Reflexive thematic analysis was used to analyse the data, with themes mapped to the relevant domains of the Theoretical Domains Framework (TDF). Results Themes highlighted how confidence and emotion underpin girls’ self-identity for PA. Girls described how their social network (i.e., peers, family, coaches and teachers) shaped their experiences of being active. Girls recognised how being active was impacted by the challenges and opportunities in their local community (e.g., lack of facilities and anti-social behaviour). Conclusion This study provides insight into low-SEP pre-teen girls’ experiences of being physically active in both rural and urban locations, while highlighting the complex interplay of individual, social and environmental factors that influence how, where and why girls engage or disengage in PA. Practical implications The use of the TDF as a theoretical lens provides an in-depth behavioural diagnosis of the factors influencing pre-teen girls’ PA, and by aligning with potential mechanisms of action this information can be used to inform future theoretically informed interventions promoting PA in pre-teen girls of low-SEP. Funding The author(s) received no specific funding for this work

Background: Access to free and safe environments for physical activity is essential for ‘physical activity security’ defined as, “access to sufficient, safe, and enjoyable opportunities for physical activity.” Purpose: To assess access to free and safe places for physical activity; and determine if access varies by area-level socioeconomic status (SES), in Austin, Texas, USA. Methods: This was an ecological, cross-sectional GIS study of Austin, Texas, USA neighborhoods, operationalized as zip codes. Public-access (free) space measures included sidewalk coverage (proportion), park-counts and recreation center-counts. Neighborhood safety was assessed with count of crimes in public spaces. Neighborhood socioeconomic status (NSES) was categorized as high/low using Austin’s median household income as the cut-point. An “access and safety score” was calculated for each neighborhood by summing asset/variable-specific scores of 0 to 2, where 0 was indicated lack of positive assets or negative circumstances (e.g., no parks or high crime), 1 for medium values, and 2 for positive values (e.g., many parks, low crime), with a possible overall score range of 0-8. Neighborhoods were then categorized as having low (0-2), medium (3-5), or high (6-8) overall access and safety score. T-tests assessed differences in access and safety scores by NSES. Results: Three-quarters of zip codes (75.9%) in Austin had a medium access and safety score, a fifth (20.3%) had a low score, and 3.7% had a high score. Marginally significant differences (p= 0.07) were observed by NSES. Conclusions: An alarmingly low number of Austin neighborhoods have high access to free and safe places for physical activity, putting many residents at risk of physical activity insecurity. Practical Implications: Austin must invest in improving the quantity, quality, and safety of public access places for physical activity, with emphasis on low-income areas, where residents are more likely to exclusively rely on public access locations for activity. Funding: N/A.

Background: Currently, the model ‘Necessity Versus Choice’ seems explain to physical inactivity (PI) patterns in middle-income countries, where people in social disadvantage use physical activity as only possibility of transportation or work. Purpose: Describe physical inactivity (PI) according to domains, as well as its correlation with two country-level socioeconomic indicators: per capita Gross domestic product (GDP) and Fragility State Index (FSI). Methods: Ecological analysis using data from cross-sectional surveys in 50 middle-income countries. PI data was obtained from the World Health Organization (WHO) STEPwise Approach to Non-communicable Disease Risk-Factor Surveillance. Our outcomes were total and domain-specific PI. For total PI, Individuals not reaching 150 minutes/week were considered as inactive. For domain-specific PI, individuals with zero minutes of physical activity were considered as inactive. We correlated each PI outcome with GDP and FSI – multidimensional measure including four domains (economic, political, social and cohesion). Results: Total PI median prevalence was 17.2%, ranging from 1.3% in Malawi to 62.6% in Kwait. Median prevalence according to domains were as follows: leisure-time 76.7% (33.4% in Mongolia to 97.0% in Eritrea); transportation 27% (8.8% in Comoros to 81.3% in Kwait); work 39.5% (3.1% in Malawi to 88.1% in Lebanon). We found a week correlation between PI outcomes and GDP (<0.2). On the other hand, FSI was positively correlated with leisure- time PI (0.54) and showed an inverse correlation with transportation (-0.25) and work (-0.36) PI. Conclusions: PI is correlated to FSI in different directions depending on domain analysed. Practical implications: Understanding the socioeconomic dynamics of PI across its domains in different contexts could help understanding the meaning of this behaviour at populational level, helping to guide future policy and promotion strategies. Funding: This project is funded by FAPERGS (Foundation for the Support of Research in the State of Rio Grande do Sul) (grant: 21/2551-0000670-6).

Background: Despite the established benefits of physical activity, most Canadian youth do not meet guidelines. Youth can attain physical activity through organized sport, both at school and in the community, which is associated with physical, mental, and social health benefits. Unsurprisingly, youth who participate in sport are more likely to be physically active. Purpose: The objective was to assess sport participation (intramural, varsity, and community) among a sample of Canadian youth over time and determine if known sociodemographic inequities resulted in disparities in participation. Methods: Data from youth in grades 9 to 11 (Sécondaire III to V in Québec) in the COMPASS Study across Canada from 2012 to 2023 were used. Prevalence of sport participation was assessed each year for the overall sample, as well as by sociodemographic variables (sex, race/ethnicity, relative family affluence, and grade). Logistic regression models were constructed to examine temporal trends in participation. Results: Alarmingly, the proportion of youth participating in no sports has increased from 33.5% in 2012 to 39.2% in 2023. Among all youth, intramural and varsity participation remained consistent from 2012-2019 followed by a decline due to COVID-19 with estimates rebounding in 2023. Community sport participation was experiencing a decline prior to COVID-19, which has been further exacerbated. Overall, females, racialized youth, those with lower perceived family affluence, and older youth participated in less organized sport. Interestingly, older youth have showed significant decreases, whereas younger youth have remained relatively stable. Conclusions: Sport participation among youth in Canada remains low and trends observed are undesirable among youth facing inequities. The largest declines are seen among community sport participation, which may speak to accessibility and financial constraints. Practical Implications: Programming to increase accessibility of sport participation opportunities, physical literacy education initiatives, and increased funding for sport training/equipment may lead to increased participation.

Purpose: Describe multiple sources of inequalities in moderate-to-vigorous physical activity (MVPA) among UK adolescents and verify their potential intersectionality. Methods: Millennium Cohort Study (age 14 wave) participants wore wrist-worn GENEActive accelerometers for 2 days; MVPA was calculated using 5 seconds epochs and 1-minute bouts. Sources of inequality were based on the PROGRESS Plus framework: sex, disability, ethnicity, language spoken at home, religion, income quintiles, area of residence, and country. Multilevel linear regression analysis was performed, considering individual, family, and environmental levels, based on a preconstructed model. Intersectionality analyses used composite variables by adding sex to each inequality source. Results: Of the 6206 adolescents included in the analyses, 51.3% were female, 93% reported no disability, and 88.1% self-identified as White. Male adolescents recorded on average 15 minutes more MVPA than females (Mean Females: 55.6; 51.7:59.5, Males: 70.6; 67.7: 73.6). Analysis considering single sources of inequality showed lowest mean minutes in MVPA for adolescents living with hearing disability (vs. no disability: -23.5; -44.4: -2.5), identifying as Pakistani/Bangladeshi ethnicity (vs. white: -24.9; -29.6: -20.1), and those in the poorest income quintile (vs. wealthiest quintile: -11.4; -20.5: -2.3,). Intersectionality analysis used the most advantaged females as reference, revealing much lower MVPA for female adolescents living with social/behavioural disability (vs. no disability/female: -30.4; -47.3: -13.6), from Pakistani/Bangladeshi ethnicity (vs. white/female: -28.4; -34.1: -22.7), who speak only/mostly a foreign language at home (vs. only/mostly English/female: -20.4; -27.3: -13.5), and those in the poorest income quintile (vs. wealthiest/female: -18.6; -29.6: -7.6). No differences were found with males. Conclusion: Adolescents with a disability, a Pakistani/Bangladeshi ethnicity, speaking a foreign language, and having low income showed lowest MVPA. Being female and belonging to one of those groups adds another layer of inequality for MVPA. Funding: None

Abstract Background: People from Black, Asian and minority ethnic backgrounds and/or those from deprived backgrounds, women, the elderly and disabled are less engaged with nature and the landscape, less likely to access the outdoors and more likely to be physically inactive. The natural environment has the potential to improve physical and mental health, which in turn can lead to reduced mortality and savings in health costs if everyone had equal access. Exploring the barriers and co-creating solutions provides useful information for planners and local and national policy-makers. Purpose: To explore the barriers and co-create solutions supporting diverse communities to use greenspaces and the countryside. Methods: Qualitative focus groups with people from diverse backgrounds in an urban, deprived, ethnically diverse town in southeast England. Results: The findings revealed a range of barriers from a lack of information and awareness of greenspaces and the countryside, lack of time, the availability and cost of transport, lack of facilities such as toilets, benches, restaurants, parking and facilities for people with disabilities, poor maintenance of facilities, safety issues and antisocial behaviour, racism and discrimination and fear of unleashed dogs. Discussion also highlighted the importance of creating awareness about greenspaces and the countryside through improved information and awareness. Conclusions: This study has provided timely information planners and local and national policy-makers across the UK on the barriers to accessing greenspaces and the countryside experienced by diverse communities. The findings can be used to generate policy recommendations and co-create collaborative, targeted outreach interventions. Practical conclusions: This study has identified the barriers and solutions for improving access to greenspaces and the countryside for diverse communities which can be used to develop intervention design. This will ensure that interventions are evidence-based and community-driven to ensure increased relevance and impact. Funding: Chilterns Conservation Board (CCB)