A survey of young people’s physical activity in Greece using the

stages of change model

Introduction

Young people’s physical activity is linked to a plethora of short- and long-term health benefits such as weight management, building and maintaining a healthy musculoskeletal and cardiovascular system, fostering mental health and establishing a healthy lifestyle from an early age (Stensel et al., 2008; Janssen & LeBlanc, 2010). However, a large percentage of young people seem to be deprived of the benefits of a physically active lifestyle (Currie et al., 2004; Dobbins et al., 2009). Especially in Greece the prevalence of physical activity in young people is impressively low; among the lowest between the European Union member states (Tzormpatzakis & Sleap, 2007). Methods

The current project was conducted by 1st grade Lyceum students in the school year 2013-14 as part of their research work course. Its purpose was to examine physical activity levels of young people in Greece, particularly the students of our school. A total of 198 students took part (age range=15-17 years, mean age=16 years, SD=0.81), which was the total number of students of our school (see: Table 1).

This study was based upon the stages of behavior change model which has been successfully employed in the investigation of young people’s physical activity (Nigg, 2001; Nigg, 2002). It suggests that behavior change is channeled through a series of stages. For physical activity the most commonly used are:

Stage 1: They are not physically active on a regular basis, and they do not intend to become in the next 6 months (Precontemplation).

Stage 2: They are not physically active on a regular basis, but they intend to become in the next 6 months (Contemplation).

Stage 3: They are not physically active on a regular basis, but they intend to become in the next 30 days (Preparation).

Stage 4: They are physically active on a regular basis, but for less than 6 months (Action).

Stage 5: They are physically active on a regular basis, for less than 6 months (Maintenance).

In order to identify each student’s stage of change questionnaires were administered in class. They were completed from November to December 2013 during the first five minutes of a Physical Education lesson. The questionnaires could be employed with confidence since they have been validated for a similar population (Tzormpatzakis, 2012); showing high concurrent validity with a combination of heart-rate monitors and activity diaries (Spearman rho=0.76, p=0.00; n=15) and also high 2-week test-retest reliability (ICC = 0.92, n = 0.61).

According to international guidelines (Cavill et al., 2001; USDHHS & USDA, 2005) in order to obtain the health benefits that derive from physical activity a young person should accumulate at least 60 minutes of moderate physical activity 5 days/week; or 20 minutes of vigorous physical activity 3 days/week; or a combination of the two. Thus, this criterion was set in the questionnaires in order to distinguish between active and inactive students. Nevertheless, self-administered questionnaires is not an objective measure of physical activity, which impose some limitations in our results, but it is considered a common shortcoming in this field of research (Dobbins et al., 2009).

Results

The largest proportion of the students (63%) were found to be physically active either in stage 4 or 5 (see: Figure 1). Actually, 53% were in stage 5 alone meaning that they had maintained their active lifestyle for more than 6 months. The 1st grade revealed the highest percentage of active students (78%), falling to 63% in the 2nd grade and even more to 50% in the 3rd grade (see: Figure 2). Boys showed a higher active percentage than girls (75% vs. 54%) (see: Figure 3).

Discussion – Conclusions

The majority of the students seemed to be active. Boys seemed to be active in higher proportions than girls. The younger ages seemed to be active in higher proportions than the older ones. Thus, the problem of inactivity seemed to be more intense among girls and the older students. In general, while the largest proportion of young people seemed to be active those that promote and deliver physical activity services should place special emphasis among girls and the older students that seem to be more prone to inactivity.

Figure 1. Stages of change of physical activity in the whole school.

Table 1. Sample characteristics.

Figure 3. Stages of change of physical activity by gender.

References

Cavill N, Biddle S and Sallis J. (2001) Health enhancing physical activity for young people: Statement of the United Kingdom expert consensus conference. Pediatric Exercise Science 13: 12-25 Currie C, Roberts C, Morgan A, et al. (2004) Young people’s health in context. Health behaviour in school-aged children (HBSC) study: International report from the 2001/2002 survey. Copenhagen: World Health Organisation: Regional office for Europe.Dobbins M, De Corby K, Husson H, et al. (2009) School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18 (Review). The Cochrane Library. The Cochrane Collaboration.Janssen I. and LeBlanc A. (2010) Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. International Journal of Behavioral Nutrition and Physical Activity 7: 40-55.Nigg C. (2001) Explaining adolescent exercise behavior change: A longitudinal application of the transtheoretical model. Annals of Behavioral Medicine 23: 11-20.Nigg C. (2002) Physical activity assessment issues in population-based interventions: A stage approach. In: Welk G (ed) Physical Activity Assessments for Health-Related Research. Champaign, IL: Human Kinetics, 227-239. Stensel D, Gorely T and Biddle S. (2008) Youth health outcomes. In: Smith A and Biddle S (eds) Youth Physical Activity and Sedentary Behavior: Challenges and Solutions. Champaign, IL: Human Kinetics, 31-57.Strong W, Malina R, Blimkie C, et al. (2005) Evidence based physical activity for school-age youth. Journal of Pediatrics 146: 732-737. Tzormpatzakis N. (2012) A transtheoretical model intervention to help Greek students adopt and maintain a physically

active lifestyle. Department of Sport, Health & Exercise Science. Hull, University of Hull. PhD, Retrieved from: https://hydra.hull.ac.uk/assets/hull:7108a/content Tzormpatzakis N and Sleap M. (2007) Participation in physical activity and exercise in Greece: A systematic literature

review. International Journal of Public Health 52: 360-371.US Department for Health and Human Services and US Department of Agriculture. (2005) The dietary guidelines for Americans, 2005 (6th ed.). Washington, DC.

Figure 2. Stages of change of physical activity by grade.

   Total

 Boys

 Girls 1st grade 2nd grade 3rd grade

Count 

198 82 116 66 68 64

Percentage 

100% 41% 59% 33% 35% 32%

0%

13%9% 8%

70%

8%13% 13%

50%

30%

4%

10%

40%

16%16%

0%

10%

20%

30%

40%

50%

60%

70%

80%

Stage 1 Stage 2 Stage 3 Stage 4 Stage 5

1st grade

2nd grade

3rd grade

8%

20%

9% 10%

53%

0%

10%

20%

30%

40%

50%

60%

Stage 1 Stage 2 Stage 3 Stage 4 Stage 5

10%14%

61%

9% 10%7% 8%

27%

7%

47%

0%

10%

20%

30%

40%

50%

60%

70%

Stage 1 Stage 2 Stage 3 Stage 4 Stage 5

Boys

Girls

Was awarded merit at national level in the Poster competition of the “International Statistical Literacy Project” of the International Association for Statistical Education