The national environment and adolescent physical activity: a multilevel study in 29 European countries

Abstract

Worldwide, roughly 80% of adolescents fail to meet World Health Organization (WHO) recommendations regarding moderate- to vigorous-intensity physical activity (MVPA) and vigorous-intensity activity (VPA). This study, based on ecological theory, explored whether national environmental differences explained variation across Europe in adolescent MVPA and VPA. Our hypotheses suggested eight environmental factors (covering physical, socio-cultural, economic, and political factors) would affect physical activity. Using the data of 138,014 11- to 15-year-olds from 29 European countries in the 2013/2014 Health Behaviour in School-aged Children (HBSC) study, we used multilevel regression models to test associations between country-level environmental variables and individual-level physical activity. The environmental variables explained 31% of country-level variance in MVPA and 74% of country-level variance in VPA. Higher community safety, lower temperature and lower household income were significantly associated with more MVPA. More urbanisation, lower temperature and higher household income were significantly associated with more VPA. The findings showed that national differences in the physical, socio-cultural and economic environment were related to adolescent physical activity, and proposed avenues for future research looking at interactions between individual and environmental factors.