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Factors associated with low fitness in adolescents – A mixed methods study

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Author
Charlton, Richard
Gravenor, Michael
Rees, Anwen
Knox, Gareth
Hill, Rebecca
Rahman, Muhammad
Date
2014-07-29
Acceptance date
2014-07-10
Type
Article
Publisher
BMC
ISSN
1471-2458
Metadata
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Abstract
Background: Fitness and physical activity are important for cardiovascular and mental health but activity and fitness levels are declining especially in adolescents and among girls. This study examines clustering of factors associated with low fitness in adolescents in order to best target public health interventions for young people. Methods: 1147 children were assessed for fitness, had blood samples, anthropometric measures and all data were linked with routine electronic data to examine educational achievement, deprivation and health service usage. Factors associated with fitness were examined using logistic regression, conditional trees and data mining cluster analysis. Focus groups were conducted with children in a deprived school to examine barriers and facilitators to activity for children in a deprived community. Results: Unfit adolescents are more likely to be deprived, female, have obesity in the family and not achieve in education. There were 3 main clusters for risk of future heart disease/diabetes (high cholesterol/insulin); children at low risk (not obese, fit, achieving in education), children ‘visibly at risk’ (overweight, unfit, many hospital/GP visits) and ‘invisibly at risk’ (unfit but not overweight, failing in academic achievement). Qualitative findings show barriers to physical activity include cost, poor access to activity, lack of core physical literacy skills and limited family support. Conclusions: Low fitness in the non-obese child can reveal a hidden group who have high risk factors for heart disease and diabetes but may not be identified as they are normal weight. In deprived communities low fitness is associated with non-achievement in education but in non-deprived communities low fitness is associated with female gender. Interventions need to target deprived families and schools in deprived areas with community wide campaigns.
Journal/conference proceeding
BMC Public Health;
Citation
Charlton, R., Gravenor, M.B., Rees, A., Knox, G., Hill, R., Rahman, M.A., Jones, K., Christian, D., Baker, J.S., Stratton, G. and Brophy, S. (2014) 'Factors associated with low fitness in adolescents–a mixed methods study', BMC Public Health, 14(1), p.764. DOI: 10.1186/1471-2458-14-764.
URI
http://hdl.handle.net/10369/10862
DOI
https://doi.org/10.1186/1471-2458-14-764
Description
Article published in BMC Public Health on 29 July 2014, available at: https://doi.org/10.1186/1471-2458-14-764.
Rights
http://creativecommons.org/licenses/by/2.0
Sponsorship
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
This study was funded by a studentship from the Economic and Social Research Council and from grant funding from the Welsh Assembly Government (H7-3-016)
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