Abstract
The benefits of physical activity (PA) on children's health and well-being are well established. However, many children do not meet the PA recommendations, increasing their risk of being overweight, obese, and non-communicable diseases. Environmental characteristics of homes and neighborhoods may constrain a child's ability to engage in PA, but evidence is needed to inform country-specific interventions in understudied low-income countries. This study assessed the associations between parental-perceived home and neighbourhood, built environment characteristics, and moderate-to-vigorous physical activity (MVPA) among children in Kampala city, Uganda. In this cross-sectional study, data were obtained from 256 children (55.5% girls) aged between 10 and 12 years and their parents. Children's MVPA was measured using waist-worn ActiGraph accelerometers. The environments were assessed using a valid self-reported parent survey. Linear regression models with standard errors (clusters) were used to analyze the relationship between environmental variables and children's MVPA. Sex-specific relationships were assessed using sex-stratified models. Play equipment at home (β = -2.37, p <0.001; unexpected direction), residential density (β = 2.70, p<0.05), and crime safety (β = -5.29, p <0.05; unexpected direction) were associated with children's MVPA. The sex-specific analyses revealed more inconsistent patterns of results with a higher perception of land use mix associated with less MVPA in girls (irrespective of school type attended), and higher perceptions of sidewalk infrastructure (β = -12.01, p <0.05) and walking and cycling infrastructure (β = -14.72, p <0.05) associated with less MVPA in girls attending public schools only. A better perception of crime safety was associated with less MVPA among boys and girls attending private schools (β = -3.80, p <0.05). Few environmental characteristics were related to children's MVPA in Uganda, and findings were largely inconsistent, especially among girls. Future studies are needed to understand the ecological determinants of health-related PA behaviors among children in Uganda.
Highlights
Childhood physical activity (PA) is a lifestyle behavior that protects against various non-communicable diseases (NCDs) and tracks through adolescence and into adulthood [1, 2]
Public school children engaged in 26 minutes more moderate-to-vigorous physical activity (MVPA) than private school children
We found few and inconsistent associations of the home and neighborhood environments with children’s MVPA, which replicated the patterns of evidence on this topic in LMICs [28]
Summary
Childhood physical activity (PA) is a lifestyle behavior that protects against various non-communicable diseases (NCDs) and tracks through adolescence and into adulthood [1, 2]. There is evidence on the importance of individual characteristics (e.g., age, sex, weight status) on children’s PA [3, 4, 6,7,8,9,10,11], such socio-demographic factors cannot fully explain the insufficient PA exhibited by the majority of children. Interventions based on such evidence may only benefit a few individuals who deliberately want to be active and have generated limited effects [12]
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