1. LEVELS OF PHYSICAL ACTIVITY AND FACTORS FOR DECREASED PHYSICAL ACTIVITY IN SECONDARY SCHOOL CHILDREN JAMSHED TOWN, KARACHI Ismat Jabeen Rukhsana W Zuberi Family Medicine, AKU 17 th National Health Sciences Research SymposiumFebruary 27, 2014

2. Background & Rationale There is a growing incidence of physical inactivity (PI) globally Childhood physical activity (PA) patterns lay down future adult activity habits Childhood PA is the 1 st line of prevention for adult NCDs PI is the 4 th most preventable risk of worldwide mortality 2

3. Objectives To determine PA levels among secondary school-children in Jamshed Town, Karachi Factors related to PI Methods Study Design: Cross sectional study Sample Size: 216 secondary school children Sampling Technique: Simple random 3

4. Methods Sample Selection Inclusion: Children in grades VI–VIII, who  informed assent Exclusion: Physically and mentally challenged Absent on the days of data collection Refused to give informed assent Ethical Considerations Approval by AKU Ethical Review Committee Confidentiality was maintained Verbal and written informed consent was taken 4

5. Methods: Questionnaire Pre-tested coded PAQ-C: Demographics & PA levels Questionnaire about Factors: related to PA – Parental support in PA – Parents & other siblings PA – Parent education – Mother employment status – Playground in school & neighborhood – Physical education classes in school – Leisure time activities: watching TV, listening to music, playing computer games, reading books, doing homework, playing cards, playing indoors, talking on the phone 5

6. Methods Analysis: Data analyzed on SPSS-16 Chi-Square (95% CI) to identify factors for PI Univariate and Multivariate Regression to identify the most important factors for PI 6

7. Results: Levels of PA (Overall) 7 N=216, n=109 (Private Schools), n=107(Public Schools)

8. Levels of PA in Private and Public Schools 8

9. Significant Factors For Levels of PA in Both Private and Public Schools 9 7 Factors for PA by  2 PA Levelp-Value Low n (%)Mod. n (%) Public/Private School 41 (63.1) 68 (45) 0.015 24 (36.9) 83 (55) Gender Male, Female 14 (21.5) 71 (47) <0.001 51 (78.5) 80 (53) Parental support 48 (73.8) 129 (85.4) 0.042 17 (26.2) 22 (14.6) Playgrounds in School 41 (63.1) 120 (79.5) 0.011 24 (36.9) 31 (20.5) Listening to Music 34 (52.3) 101 (66.9) 0.042 31 (47.7) 50 (33.7) Doing Homework 51 (78.5) 143 (94.7) <0.001 14 (21.5) 8 (5.3) Playing indoors 13 (20) 55 (36.4) 0.017 52 (80) 96 (63.1)

10. Significant Factors For Levels of PA in Private Schools 10 P value < 0.05

11. Significant Factors For Levels of PA in Public Schools 11 p value < 0.05

12. Univariate Regression Analysis Univariate FactorsOR (CI)p-value School: Public/ Private 2.085 (1.14-3.78) 0.016 Gender: Male/ Female 3.23 (1.6-6.3) 0.001 Parental support for PA 2.077 (1.01-4.2) 0.045 Playground in School 2.26 (1.19-4.29) 0.012 Listening to Music 1.84 (1.01-3.3) 0.044 Doing homework 4.9 (1.94 – 12.3) 0.001 Playing indoors 2.292(1.17-4.57) 0.019 12

13. Multivariate Regression Analysis Multivariate MV FactorsAdjusted OR (CI)p value School Public 2.22 (1.145-4.31) 0.018 Private 1 Gender Male 4.2 (2.0-8.8) <0.001 Female 1 Parental support in PA Yes 2.34 (1.05-5.2) 0.037 No 1 Doing homework Yes 3.89 (1.46-10.35) 0.006 No 1 Playing with indoor Yes 2.67 (1.25-5.6) 0.011 No 1 13

14. 14 Conclusion About 30% school-children had low PA levels & 70% had moderate. NOT a single child had high activity level Model for Inactivity: Girl in a Private school, without parental support for sports Model for Activity: Boy in a public school with parental support, doing homework and playing indoors regularly Recommendations Interventions should emphasize on awareness among parents to increase support for sports Girls and students in private schools should be targeted with a special focus on participation in sports

15. References Global recommendations on physical activity for health. WHO, 2010 Global health risks: mortality and burden of disease attributable to selected major risks. WHO, 2009 Physical Activity guidelines for Americans. 2008 Physical activity guidelines for children and adolescents. Paediatr Child Health. 2012 Playground Designs to Increase Physical Activity Levels During School Recess: A Systematic Review. Health Educ Behav. 2013. School-based physical activity programme in preadolescent girls (9-11 years): a feasibility trial in Karachi, Pakistan. Arch Dis Child. 2013 Interventions for preventing obesity in children. Cochrane Database Syst Rev.2011 School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18. Cochrane Database Syst Rev. 2009 Rise in childhood obesity with persistently high rates of undernutrition among urban school-aged Indo-Asian children. Arch Dis Child. 2008 Measuring activity in children and adolescents using self-report: PAQ-C and PAQ-A. Med sci sports Exerc. 2008 15

16. 16 “ Stop waiting for things to happen. Go out and make them happen”