Pediatric Obesity Research Update | Physical Activity and Fitness in Children

Each month, the OMA Pediatric Committee reviews a pediatric-focused obesity research update to help keep you up to date about the latest findings. This month’s update addresses physical activity and fitness

Factors That Influence Participation in Physical Activity in School-Aged Children and Adolescents: A Systematic Review from the Social Ecological Model Perspective

Article Summary

The Social Ecological Model (SEM) includes intrapersonal, interpersonal, organizational, community, and public policy levels and offers a useful perspective for understanding child and adolescent participation in physical activity. This systematic review of 14 studies evaluated factors at different SEM levels.

Article Review

Emerging research supports that health behaviors, such as engaging in physical activity(PA), are influenced by a number of factors in the individual’s social and physical environment outside of their control and, if developed in childhood, tend to be maintained during adulthood. The Social Ecological Model (SEM) was developed by McLeroy et al. in 1988 to evaluate possible interventions at varying levels of impact. The authors of this review used the five levels of the SEM: 1) intra-personal, 2)interpersonal, 3)organizational, 4) community, and 5)public policy to attempt to understand the varied and complex factors involved in child and adolescent PA participation.

The authors conducted a systematic review of the literature published before June 2020. Of the 4,134 articles identified in the search process, 14 met their inclusion criteria (7 qualitative and 7 quantitative). All articles met high-quality standards. Twelve articles addressed the first 4 levels of SEM, and only 2 addressed the fifth level of policy. No study addressed all 5 levels. Ten articles examined PA in schools. Facilitators were more common at the interpersonal level, and barriers were most common at the community level.

The most frequently cited intrapersonal level factors were gender, self-concept, age, ethnicity, and body mass index (BMI). Boys and younger children were more active than girls and older children or adolescents. BMI was not a predictor of PA participation. Self-concept (self-efficacy, perceived health, physical self-perception, and participation motives, and perceived competence and enjoyment) was the strongest predictor of PA participation. Differences in race, ethnicity, and/or cultural backgrounds influenced PA participation. For example, children and adolescents from racially minoritized groups encountered more barriers to PA. As a result, the authors suggest that these nuanced differences should be considered when designing an intervention. Influence from friends or parents was the most important interpersonal level factor and could be either a facilitator or barrier to PA participation.

At the organizational level, teacher support, especially physical education teacher support, was important for engagement in PA, with differences in public vs. private and rural vs. urban schools. Private and rural schools encouraged PA more than public and urban schools. The mechanisms for this are not known. At the community level, neighborhood safety and accessibility to facilities were the most important factors supporting the need for affordable PA facilities. The two policy-level studies addressed the influence of provincial and municipal policies on schools more so than state and federal government policies.

This review provides useful information about the SEM factor levels that influence PA participation to help guide policymakers, researchers, and public health officials to direct resources to increase PA, reduce health disparities, and reduce child and adolescent obesity.

Additional Resources

Find more resources curated by OMA’s Pediatric Committee on our Pediatric Resources page. There you’ll find additional article reviews on various topics related to obesity as well as public resources for clinicians and families.