A Multilevel Examination of Factors of the School Environment associated with Time Spent in Physical Activity among a sample of Secondary Students in Ontario, Canada.

Abstract

Background: The high prevalence of children and adolescents not meeting the recommended 60 minutes of physical activity (PA) per day and the associated negative health consequences make it critical to increase PA. Ecological models suggest that the school environment may influence student health behaviour. However, few studies have examined the school environment in relation to student PA. Purpose: To examine between-school variability in students’ time spent in PA, and identify factors of the school built environment that account for the between-school variability in students’ time spent in PA overall as well as by gender and school location, while also considering school physical education (PE) and PA programming and controlling for student-level characteristics and potential environment-level confounders. Methods: This thesis consisted of a secondary data analysis of the School Health Action, Planning and Evaluation System (SHAPES) Ontario project, which included self-report data from administrators and 25,416 students in 76 secondary schools across Ontario. The student- and school-level survey data were supplemented with GIS-derived measures of the built environment within 1-km buffers of the 76 schools. Multilevel modeling was used to examine between-school variability in students’ time spent in PA, as well as environment-level factors associated with PA. Results: There was significant between-school variability in students’ time spent in PA overall as well as by gender and school location, respectively. Schools having another room for PA and schools offering daily PE were positively associated with students’ PA. Schools located in areas with higher land-use mix diversity and walkability were negatively associated with students’ PA. Results of the gender-specific multilevel analyses indicated schools should consider providing another room for PA, especially for offering flexibility activities directed at female students. Schools should also consider offering daily PE to male students in senior grades. Students attending schools in urban and suburban areas that provided another room for PA or were located within close proximity to a shopping mall or fast food outlet spent more time in PA. Conclusions: These findings support the ecological notion that the school environment can influence student PA behaviour. A better understanding of the relationship between the school environment and PA will assist in the development of effective school-based policies, programs and interventions to increase PA.