A health promotional physical activity programme for adolescents in a semi-urban community : PLAY-study
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Physical activity (PA) and physical fitness (PF) are regarded as important elements of a healthy lifestyle (Sallis & Patrick, 1994:304; Saxena et al., 2002; Beets & Pitetti, 2004:1796). Literature revealed that adolescents are more inclined to be physically inactive and spent time on sedentary activities, such as watching television (Wang & Biddle, 2001:1; Marshall et al., 2002:413; Neumark-Sztainer et al., 2003:803; Hancox et al., 2004; Malina et al., 2004:479). Adolescents from low socio-economic communities also experience various other barriers, such as performing income-generating activities and family duties (Prista et al., 1997:455; Kriska, 2000:50), time constraints (Saxena et al., 2002), too much homework (Deflandre et al., 2004:31) and distances from sports facilities (Nahas et al., 2003), which prevent them from being physically active. Stunting, defined as height growth retardation, is also a condition that is associated with poor socio-economic status (SES) and various studies showed an occurrence of up to 19% in children (Kruger et al., 2004:566; Cameron et al., 2005:414). Although different intervention studies were conducted to improve stunting, none were based on physical activity intervention (Lunn, 2002:109; Walsh et al., 2002:6). The first aim of the study was to determine the physical fitness status and physical activity levels of 15-year-old adolescents from a previously disadvantaged community. Secondly, to determine what factors would be regarded as either barriers or motivators for 15-year-old adolescents from this previously disadvantaged community for improving their physical activity and participation in sport and for determining their perception of their own physical activity level. The next aim was to analyse the physical activity choices and aerobic endurance of these 15-year-old adolescents and the effect of a physical activity intervention programme (PAIP) on their physical activity choices and levels and aerobic endurance. The last aim of the study was to examine the effect of a PAIP on the physical fitness of stunted 15-year-old adolescents. Two high schools (an intervention school [school 1] and a control school [school 2]) in a previously disadvantaged community near Potchefstroom, South Africa, participated in this study. The learners in the control school had a slightly better socio-economic status, determined by income per capita. All Grade 8 learners in School 1 and 2 were requested to participate in the research. Two hundred and fifty-two (N=252) Grade 8 learners (116 boys and 136 girls) in School 1 and N=66 Grade 8 learners (21 boys and 45 girls) in School 2 parents/guardians granted informed consent to participate in the study. The PAIP was conducted for an hour twice a week for 19 weeks directly after school hours for learners from School 1. No physical education classes or organised sport were part of the school curriculum during the intervention. A pre-test/post-test study design was used. Standard anthropometrical procedures were used to determine body mass, stature and four skin folds. The Fitnessgram (Meredith & Welk, 1999:9) and additional fitness tests were used to determine the physical fitness levels of the participants. The Previous Day Physical Activity Recall (PDPAR) (Trost et al., 1999:342) was used to determine the physical activity levels and television watching hours during one day of the week and weekend respectively. Biological maturity status was determined by means of the 5-stage Tanner scale (Faulkner, 1996:237). The questionnaire of Rowland (1990) which deals with barriers to physical activity and participation in sport was also used. A few of the questions were adjusted and additional questions from Meredith and Welk (1999:50) were added. Demographic information on the SES (income per capita, housing, water and electricity) of the participants, as well as information on how far learners walked to school and how long it took, was also determined. The data was analysed by means of descriptive statistics, correlational analysis, frequency and rank ordering, t-testing followed by Tuckey post hoc analysis, One-and Two-way Analysis of Covariance (ANCOVA) and Tuckey-Kramer multiple comparisons. The Statistica for Windows and SAS computer programmes were used to analyse the data according to the above-mentioned aims of the study. A p-value smaller or equal to 0.05 was accepted as significant. The results of the study indicated higher mean physical fitness values in the intervention group compared to the control group. Both boys and girls in the intervention group and boys in the control group were moderately active, while only the girls in the control group showed low levels of physical activity. Longer commuting distances were found in the intervention group, while more hours of television watching were found in the control group. The aerobic fitness, flexibility and body composition of group 1 and 2 fell within the healthy fitness zone (HFZ), while their strength fell outside the healthy fitness zone, and showed negative relationships with aerobic fitness and flexibility. Television viewing time and commuting distances to school appeared to have a moderate influence on the moderate to low physical activity levels of the total group, and physical activity showed a relationship with higher fitness values. Regarding the second aim, too much homework, lack of money and family responsibilities were indicated as barriers to being physically active, while encouragement of parents and friends to participate with, were found to be motivational factors. After participation in the physical activity programme it was found that the learners' perceptions had changed and they had better knowledge of the intensity of physical activity. The results analysed for the third aim of the study indicated disappointing results regarding the effect of the intervention programme and no significant improvement was found, because of poor attendance to the programme. The learners had to be categorised in different attendance groups of the intervention programme. The group with the highest attendance (>70%) of the programme seemed to sustain their aerobic fitness the best. From the activities that were included in the physical activity programme, it was established that netball and soccer had a small effect on the physical activity choices of the group after participating in the programme. The results of the fourth aim revealed that stunted girls, who participated regularly in the programme, showed better improvement in aerobic fitness and hand grip strength after participating in the activity programme compared to non-stunted girls, while the lean body mass and flexibility on the right side of the body had improved in stunted boys. The stunted boys and girls also showed improvement in different physical fitness variables compared to non-stunted boys and girls. It can be concluded from the results of this study that participating in an after school physical activity programme is not the answer to improving the physical activity of children living in low SES environments. Such programmes are, however, needed but should be implemented during school hours. The physical activity programme, however, had a positive effect on both the physical fitness (excluding strength) and aerobic fitness as well as on their perception of physical activity and physical fitness of the adolescents, and showed some effect on the fitness of stunted adolescents. Intervention strategies should however be developed to overcome the barriers that prevented children from low SES communities from being physically active. It is also important to empower these adolescents with knowledge and skills to enable them to maintain and increase their physical activity levels.
- Health Sciences