Addressing Racial/Ethnic Differences in Age-Related Declines in Physical Activity During Adolescence

Abstract

See Related Article on p. 562 See Related Article on p. 562 Opportunities to be physically active are shaped by one's social environment, which can increase or decrease an individual's or community's likelihood of engaging in physical activity [[1]Braveman P. Egerter S. Barclay C. Issue brief 10: What shapes health-related behaviors, the role of social factors. Robert Wood Johnson Foundation, Princeton (NJ)2008Google Scholar]. For children, these social factors can include (but are not limited to) parental education and income, race or ethnic group, and home and neighborhood environments. Parental education, the most stable indicator of socioeconomic status (SES), can lead to both general and specific health-related knowledge and better problem-solving skills to make more informed decisions about physical activity behaviors [[1]Braveman P. Egerter S. Barclay C. Issue brief 10: What shapes health-related behaviors, the role of social factors. Robert Wood Johnson Foundation, Princeton (NJ)2008Google Scholar]. Parental education is also closely linked with employment opportunities and family income, which in turn can influence a child's physical activity environment (i.e., living in a safe neighborhood with parks and playgrounds) [[1]Braveman P. Egerter S. Barclay C. Issue brief 10: What shapes health-related behaviors, the role of social factors. Robert Wood Johnson Foundation, Princeton (NJ)2008Google Scholar]. Whereas family income increases purchasing power and access to both physical activity and sedentary resources, parental education informs purchasing decisions (e.g., buying portable play equipment rather than media-based technology) [[1]Braveman P. Egerter S. Barclay C. Issue brief 10: What shapes health-related behaviors, the role of social factors. Robert Wood Johnson Foundation, Princeton (NJ)2008Google Scholar]. Parents with higher education also tend to guide their children's choices by encouraging outdoor play or sports participation and setting household rules regarding screen time [[1]Braveman P. Egerter S. Barclay C. Issue brief 10: What shapes health-related behaviors, the role of social factors. Robert Wood Johnson Foundation, Princeton (NJ)2008Google Scholar]. Data from the Neighborhood Impact on Kids study demonstrated that children in lower-SES households had greater access to electronic media devices in their bedrooms but lower access to portable play equipment [[2]Tandon P.S. Zhou C. Sallis J.F. et al.Home environment relationships with children's physical activity, sedentary time, and screen time by socioeconomic status.Int J Behav Nutr Phys Act. 2012; 9: 88Crossref PubMed Scopus (275) Google Scholar]. In addition, household rules around outdoor play were more restrictive in lower-SES households. These differences were found across both household income and highest level of educational attainment in the household. Although children's screen time was higher in low-SES households, there were no significant differences by SES in children's overall or home-based physical activity levels or sedentary time. These findings suggest SES environments shape opportunities for physical activity and sedentary behavior but may not directly influence children's physical activity participation. The disproportionate number of black and Hispanic children situated in low-SES households [[3]The Annie E. Casey Foundation 2017 KIDS COUNT data book: State trends in child well-being.2017http://www.aecf.org/databookGoogle Scholar] would suggest that these racial/ethnic minority groups are at increased risk for physical inactivity. Yet, data from the 2003–2004 National Health and Nutrition Examination Survey indicate black children (ages 6–11 years) engage in more physical activity compared with their white and Hispanic counterparts [[4]Troiano R.P. Berrigan D. Dodd K.W. et al.Physical activity in the United States measured by accelerometer.Med Sci Sports Exerc. 2008; 40: 181-188Crossref PubMed Scopus (5427) Google Scholar]. In contrast, Hispanic children recorded the lowest physical activity participation. In all three racial/ethnic groups, physical activity declined with increasing age [[4]Troiano R.P. Berrigan D. Dodd K.W. et al.Physical activity in the United States measured by accelerometer.Med Sci Sports Exerc. 2008; 40: 181-188Crossref PubMed Scopus (5427) Google Scholar], but data from the Trial of Activity for Adolescent Girls suggested that the rate of decline is larger in black girls than in the other two racial/ethnic groups [[5]Pate R.R. Stevens J. Webber L.S. et al.Age-related change in physical activity in adolescent girls.J Adolesc Health. 2009; 44: 275-282Abstract Full Text Full Text PDF PubMed Scopus (83) Google Scholar]. Previous researchers have pointed to developmental factors (i.e., earlier onset of menarche and increased insulin resistance in blacks) to explain racial/ethnic differences in age-related changes in physical activity [5Pate R.R. Stevens J. Webber L.S. et al.Age-related change in physical activity in adolescent girls.J Adolesc Health. 2009; 44: 275-282Abstract Full Text Full Text PDF PubMed Scopus (83) Google Scholar, 6Spruijt-Metz D. Belcher B.R. Hsu Y.W. et al.Temporal relationship between insulin sensitivity and the pubertal decline in physical activity in peripubertal Hispanic and African American females.Diabetes Care. 2013; 36: 3739-3745Crossref PubMed Scopus (12) Google Scholar]. More recently, however, researchers have broadened their scope to examine social-contextual factors that shape age-related declines in physical activity in racially and ethnically diverse pediatric populations. In this issue of Journal of Adolescent Health, Barr-Anderson et al. [[7]Barr-Anderson D.J. Flynn J.I. Dowda M. et al.The modifying effects of race/ethnicity and socioeconomic status on the change in physical activity from elementary to middle school.J Adolesc Health. 2017; 61: 562-570Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar] uses a three-level socio-ecological model to identify predictors of physical activity behaviors and quantify the modifying effect of race/ethnicity and SES on age-related declines in physical activity. This model considered the complex interplay between individual, interpersonal, and environmental factors that may increase or decrease a child's likelihood of becoming and remaining physically active [8Walcott-McQuigg J.A. Zerwic J. Dan A. Kelley M. An ecological approach to physical activity in African American women.Medscape Womens Health. 2001; 6: 3PubMed Google Scholar, 9Sallis J.F. Bauman A. Pratt M. Environmental and policy interventions to promote physical activity.Am J Prev Med. 1998; 15: 379-397Abstract Full Text Full Text PDF PubMed Scopus (861) Google Scholar]. This analysis advances our understanding of which factors (and at what level) contribute to age-related declines in physical activity in black, white, and Hispanic children. Similar to previous findings [4Troiano R.P. Berrigan D. Dodd K.W. et al.Physical activity in the United States measured by accelerometer.Med Sci Sports Exerc. 2008; 40: 181-188Crossref PubMed Scopus (5427) Google Scholar, 5Pate R.R. Stevens J. Webber L.S. et al.Age-related change in physical activity in adolescent girls.J Adolesc Health. 2009; 44: 275-282Abstract Full Text Full Text PDF PubMed Scopus (83) Google Scholar], in Barr-Anderson et al.'s multiethnic cohort of 643 youth from suburban and rural South Carolina, physical activity declined from fifth to seventh grades among all racial/ethnic and SES groups. A greater percentage of black youth were in poverty, yet this racial group engaged in more physical activity compared with whites and Hispanics. Factors that influenced total physical activity and age-related changes in physical activity varied by race/ethnicity, where blacks did not share any common predictors of change in physical activity with whites and Hispanics. For example, self-efficacy, home equipment, and parent-reported sport participation were associated with changes in physical activity among black youth, whereas physical activity barriers and physical activity enjoyment predicted age-related changes in white youth. Among Hispanic youth, parent reports of children's physical activity enjoyment as well as seeing children outdoors predicted changes in physical activity in this ethnic group. Taken together, these findings shed light on the complexity of physical activity behavior and demonstrate that one size does not fit all when attempting to address physical inactivity in a racially and ethnically diverse group of children and adolescents. Currently, there are 57.5 million people of Hispanic origin and 43 million blacks in the U.S., comprising 31% of the total population [[10]United States Census Bureau Quick facts.https://www.census.gov/quickfacts/fact/table/US/PST045216Google Scholar]. Hispanics are the fastest-growing racial/ethnic group in this country, adding over seven million people to the population and increasing in size by 14% in the last 5 years [[10]United States Census Bureau Quick facts.https://www.census.gov/quickfacts/fact/table/US/PST045216Google Scholar]. With this rapid increase in racial/ethnic diversity in the U.S.,researchers have highlighted the need for tailored intervention strategies that meet the specific needs of each community [[11]Resnicow K. Baranowski T. Ahluwalia J.S. Braithwaite R.L. Cultural sensitivity in public health: defined and demystified.Ethn Dis. 1999; 9: 10-21PubMed Google Scholar]. Increasing and maintaining physical activity participation in youth requires an in-depth understanding of the factors that influence physical activity behaviors. To date, most physical activity interventions conducted in multiethnic pediatric populations use an equality-based approach to increasing physical activity participation. In essence, single-level interventions with similar educational, informational, and economic resources for increasing physical activity are provided to diverse communities, irrespective of the resources and needs that each community has to help its children achieve the recommended 60 minutes of physical activity [[12]United States Department of Health and Human Services Physical activity guidelines for Americans.2008Google Scholar]. Barr-Anderson et al.'s [[7]Barr-Anderson D.J. Flynn J.I. Dowda M. et al.The modifying effects of race/ethnicity and socioeconomic status on the change in physical activity from elementary to middle school.J Adolesc Health. 2017; 61: 562-570Abstract Full Text Full Text PDF PubMed Scopus (34) Google Scholar] findings highlight the need for equity in physical activity programming. Equity in this case refers to providing different types of physical activity resources, at multiple levels, at different time points throughout adolescence to increase and maintain physical activity participation in diverse adolescent populations. By using an equity approach to address racial/ethnic differences in age-related changes in physical activity, eliminating this disparity can become an attainable goal [[13]Hasson R.E. Brown D.R. Dorn J. et al.Achieving equity in physical activity participation: ACSM experience and next steps.Med Sci Sports Exerc. 2017; 49: 848-858Crossref PubMed Scopus (31) Google Scholar]. The Modifying Effects of Race/Ethnicity and Socioeconomic Status on the Change in Physical Activity From Elementary to Middle SchoolJournal of Adolescent HealthVol. 61Issue 5PreviewYouth physical activity (PA) levels differ by race/ethnicity and socioeconomic status (SES). It is well established that various multilevel factors may influence changes in PA. The present study examined whether the association between the change in individual, interpersonal, and environmental factors and the change in PA is modified by race/ethnicity or SES. Full-Text PDF