Evaluating the impact of participation in school-based physical education lessons on adolescent health and wellbeing in Ontario: Findings from the COMPASS study
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Date
2025-01-30
Authors
Advisor
Leatherdale, Scott
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Publisher
University of Waterloo
Abstract
Physical activity rates among adolescents in Canada are critically low; only about one in every three grade 9 students are meeting the recommended 60 minutes per day of moderate to vigorous physical activity (MVPA). These high rates of physical inactivity among youth are alarming, as physical activity is essential for both physical and mental wellbeing, and it sets the foundation for healthy habits in adulthood. School-based physical activities including physical education (PE) classes, and intramural and varsity sport programs are ideally situated for the promotion of physical activity as they can reach a large number of youth and overcome many of the barriers associated with extracurricular activities.
PE is designed to provide opportunity for youth of all ages to engage in physical activity that is structured into their weekly routine. However, in secondary school, a period that is critical for establishing healthy behaviour patterns for later in life, PE becomes non-mandatory for students in many provinces and territories across Canada, resulting in a missed opportunity to engage adolescents in regular physical activity. Ontario currently has the most lenient PE policy in Canada, with students only required to complete one secondary school-level PE course. To date, only four studies have examined the impact of PE programming in Canada on physical activity levels, only one of which included students from the province of Ontario. No published studies to date have explored the impact of PE participation on mental health outcomes among adolescents in Canada. The lack of evidence in this domain renders it challenging to determine the effectiveness of PE or make recommendations to enhance PE programs to maximize their impact on student health and wellbeing.
This dissertation aimed to provide a deeper understanding of the patterns of physical activity behaviours and the impacts of participating in non-mandatory secondary school PE on physical activity and mental health outcomes among adolescents in Ontario. Specifically, Study 1 characterized longitudinal physical activity profiles of non-mandatory PE participation, adherence to physical activity guidelines, and sport participation throughout secondary school. Study 2 quantified the impact of participation in PE on physical activity levels, over time. Study 3 quantified the impact of PE participation on student mental health, over time. This dissertation utilized linked longitudinal data from students in Ontario who participated in four consecutive years of the COMPASS Study (Time 1: 2015-16; Time 2: 2016-17; Time 3: 2017-18; Time 4: 2018-19). The COMPASS Study is a school-based prospective cohort study (2012-2027) that collects demographic, behavioural, and mental health data from students annually across Canada. Study 1 utilized a repeated measures latent class analysis to identify longitudinal physical activity profiles of adolescents in Ontario. Studies 2 and 3 utilized linear mixed models to estimate the average effect of PE participation on (a) minutes of MVPA (Study 2) and (b) symptoms of anxiety, (c) symptoms of depression, and (d) psychological wellbeing (Study 3), over time. Models in Studies 2 and 3 were adjusted using doubly robust propensity score methodology to account for self-selection biases that may influence PE participation.
Findings from Study 1 illustrated that there are distinct, clustered physical activity profiles among adolescents which vary by sex; three physical activity profiles were identified among both female and male students: Guidelines, PE & Sports, and Guidelines & Sports. A fourth profile was identified among male students only: Inactive. Study 2 demonstrated that participation in secondary school PE had a significant positive impact on MVPA levels over time, and effects were most pronounced for male students and during the semester of PE participation. Study 2 also illustrated that the benefits of PE remained present in the semester opposite to PE participation, suggesting that the benefits of PE extended beyond the MVPA accumulated during class-time. In Study 3, PE participation was not associated with symptoms of anxiety or depression, over time. Study 3 also found that male students enrolled (but not currently participating) in PE were found to have higher psychological wellbeing compared to those not enrolled in PE within the academic year.
This dissertation fills an important gap with respect to our understanding of PE programming in Ontario secondary schools. Findings from this dissertation revealed that many students are choosing not to enroll in PE, with a particularly high-risk subgroup of male adolescents showing low participation across several physical activity behaviours during secondary school. Among male students who elect to participate, PE was found to positively impact time spent in MVPA and psychological wellbeing. These results highlight the potential of PE for improving the health and wellbeing of adolescents, although low participation rates limit these benefits being experienced at the population-level. Importantly, all three studies identified sex-based differences in the physical activity profiles and the impact of PE on health outcomes; female students were found to have lower PE participation rates and experienced reduced benefits compared to male students. These result underscore the importance of promoting inclusive environments in PE to ensure health benefits are experienced by all adolescents, regardless of sex and other key characteristics. Findings from this dissertation offer valuable insights for public health programming, particularly within the school context; decision-makers in Canada should explore ways to increase PE participation across secondary schools, paying particular attention to female students and those not participating in other forms of physical activity.