Association between physical education classes and physical activity among 187, 386 adolescents aged 13-17 years from 50 lowand middle-income countries

Abstract Objective: This study aimed to examine the association between physical education classes and PA among adolescents from 50 lowand middle-income countries (LMICs). Methods: A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences. Results: Included adolescents aged from 13 to 17 years (n = 187,386, %boys = 51.7; mean age = 14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day = 1.34, 2 days = 1.66, 3 days = 1.67, 4 days = 1.79, 5 days or more = 2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I2 = 53%, p < 0.01), although the pooled OR was 1.50 (95% CI: 1.36-1.65). Conclusions: Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors.

Prevalence of Smoking and Its Associated Risk Factors Among Secondary School Students in Kelantan, Malaysia

@# Minimizing smoking initiation among adolescents has been identified as a strategy to reduce the prevalence of tobacco induced diseases among Malaysian adults. The aims of this study were to investigate the prevalence and factors associated with smoking among secondary school- going adolescents in the state of Kelantan, Malaysia. Methods: A school-based survey was carried out in Kelantan to determine the prevalence and associated factors of smoking among Kelantanese adolescents. Two-stage cluster sampling was used to ensure the representativeness of the sample. A self-administered validated questionnaire was utilised to obtain data from the selected respondents. Multiple logistic regression analysis was used to determine the factors associated with smoking behaviour among school-going adolescents. Results: The study revealed that 10.1% (95 CI 8.5-11.9%) of the selected respondents were current smokers. The prevalence of male who smoked was significantly higher compared to female. MLR revealed that, males, respondents with at least one smoking parent/guardian, as well as the respondents with less supportive parents/ guardian were more likely to smoke. However, by having a few numbers of close friends and helpful peers in the school had shown no significant association for being the current smokers. Conclusion: The study showed that the prevalence of smoking was a bit lower than the national prevalence, and smoking behaviour was predominant among male adolescents in Kelantan state. Comprehensive measures with the involvement of parents/guardians were imperative to tackle smoking habits among adolescents by targeting high-risk groups identified in the study.