Eimear Keane - Physical activity, screen time and risk of psychosomatic health complaints in school-aged children

Eimear Keane - Physical activity, screen time and risk of psychosomatic health complaints in school-aged children

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  PHYSICAL ACTIVITY, SCREENTIME AND THE RISK OF SUBJECTIVE HEALTH COMPLAINTS IN SCHOOL-AGED CHILDREN Presenting author: Dr Eimear Keane Co-authors: Drs Colette Kelly, Michal Molcho & Saoirse Nic Gabhainn
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  WHAT ARE SUBJECTIVEHEALTH COMPLAINTS? • Subjective health complaints are somatic (e.g., headache, backache) and psychological (e.g., feeling low, feeling nervous) symptoms that cannot be explained by an underlying illness • Subjective health complaints are thought to reflect a significant dimension of wellbeing • They are prevalent in children, particularly in girls and symptoms can co-occur • They are associated with medicine use, an increased demand for primary care service use and school absenteeism
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  PHYSICAL ACTIVITY • Regularphysical activity is essential for normal growth and development and has several benefits for health and wellbeing • The World Health Organisation (WHO) recommends that children engage in at least 60 minutes of moderate-to- vigorous physical activity (MVPA) daily • Recent evidence from 32 countries in Europe and North America suggests that 14% of girls and 23% of boys aged 11- 15 years currently meet MVPA recommendations
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  SEDENTARY BEHAVIOUR • Thereis a dose-response relationship between sedentary behaviour and poor outcomes in childhood e.g. obesity and low self-esteem • A European study has estimated that children aged 12-18 years spend 70% of their waking time sedentary • Screen time is a distinct type of sedentary behaviour - many children have access to multiple types of screens • Recommendation - children should not exceed two hours of total screen time (TST) per day • More than half of all children are not meeting TST recommendations
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  AIMS 1. This studydescribes the prevalence of eight subjective health complaints in a large, nationally representative sample of girls and boys aged 10-17 years 2. We examine the independent association of meeting (1) physical activity and (2) TST recommendations on the risk of reporting health complaints weekly or more 3. Finally, this study explores the impact of meeting both, one or neither recommendation (physical activity and TST) on the risk of reporting health complaints weekly or more
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  METHODS: HBSC IRELAND2014 Sampling Frame Department of Education and Skills school lists 230 schools participated Response rate = 59% Cluster sample of students within classrooms 13611 students participated Response rate = 84.5% Self-completed questionnaire filled in at school Target population School going children aged 9-18 years Sampling is proportionate to the distribution of students across geographical regions
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  VARIABLES OF INTEREST SOCIO-DEMOGRAPHICS Age group Gender (Social class) EXPOSURE Physical activity (WHO recommendations of 60 minute/day) TST measured using 3 screen activity questions on week & weekend days (Recommendation <=2 hours/day) OUTCOME HEALTH COMPLAINTS 1. Headache 2. Stomach-ache 3. Backache 4. Feeling low 5. Irritability or bad temper 6. Feeling nervous 7. Difficulties in getting to sleep 8. Feeling dizzy Five response options were dichotomised for each health complaint as either: (1) Less than weekly (2) Weekly or more frequently
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  STATISTICAL METHODS • Prevalenceestimates were estimated • Chi squared tests were used to test for significant differences in socio-demographics and lifestyle factors (physical activity and TST) • Possible interactions between gender and physical activity, and gender and TST were tested • To assess if lifestyle behaviours (physical activity and TST) were associated with the risk of health complaints, separate poisson regression models were examined • Statistical analysis was conducted in Stata 12 IC (StataCorp LP, USA)
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  PREVALENCE OF HEALTHCOMPLAINTS, BY GENDER 0% 10% 20% 30% 40% 50% 60% Girls Boys
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  CHARACTERISTICS OF THESTUDY POPULATION (10474), BY GENDER Girls N=6132 (58.5%) Boys N=4342 (41.5%) % % Met TST recommendations Yes 21.8 24.4 No 78.2 75.6 Met MVPA recommendations Yes 16.3 30.1 No 83.7 69.9 Compliance to recommendation groupings Met both 5.1 8.7 Met TST only 11.2 21.2 Met MVPA only 16.5 15.1 Met neither 67.3 55.0
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  PREVALENCE OF HEALTHCOMPAINTS IN GIRLS AND BOYS WHO MET PHYSICAL ACTIVITY RECOMMENDATIONS 29 19 21 15 28 17 35 33 37 21 24 19 36 22 46 36 Girls Boys Girls Boys Girls Boys Girls Boys Headache Backache Feeling low Irritability Yes No
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  PREVALENCE OF HEALTHCOMPAINTS IN GIRLS AND BOYS WHO MET TOTAL SCREEN TIME RECOMMENDATIONS 28 18 18 13 25 17 31 27 38 22 25 19 37 23 48 38 Girls Boys Girls Boys Girls Boys Girls Boys Headache Backache Feeling low Irritability Yes No
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  THE RISK OFREPORTING HEALTH COMPLAINTS WEEKLY OR MORE BY PHYSICAL ACTIVITY AND TOTAL SCREEN TIME RECOMMENDATIONS Headache Backache Feeling low Irritability IRR(95% CI) Met MVPA recommendations 1.0 1.0 1.1 1.1 (0.9-1.1) (0.9-1.0) (1.0-1.2) (1.0-1.2) Met TST recommendations 1.2 1.2 1.3 1.4 (1.1-1.3) (1.1-1.4) (1.2-1.5) (1.3-1.5) *Models are adjusted for gender, age group, and either physical activity or TST recommendations
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  ASSOCIATION BETWEEN ADHERENCETO MEETING BOTH, ONE OR NEITHER RECOMMENDATION AND THE RISK OF REPORTING HEALTH COMPLAINTS WEEKLY OR MORE Headache Backache Feeling low Irritability IRR(95% CI) Met both ref ref ref ref Met TST only 1.2 1.2 1.1 1.1 (1.0 -1.4) (0.9-1.6) (0.9-1.3) (0.9-1.3) Met MVPA only 1.3 1.5 1.4 1.4 (1.1-1.7) (1.1-2.0) (1.1-1.6) (1.2-1.6) Met neither 1.3 1.4 1.5 1.5 (1.1-1.6) (1.1-1.8) (1.2-1.7) (1.3-1.7) *Models are adjusted for gender and age group
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  STRENGTHS AND LIMITATIONS Strengths •A large, nationally representative sample • The questionnaire items have been previously validated • Though self-reported screen time data may not provide accurate estimates, it is appropriate to ranking individuals Limitations • Our measures are subjective and self-reported • Residual confounding is a possibility • As this study is cross sectional, temporal associations are possible and causality cannot be inferred
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  CONCLUSIONS • The prevalenceof health complaints was high in school-aged children • Poor lifestyle behaviours co-existed in two-thirds of girls and just over half of boys suggesting that population level measures are warranted to tackle poor lifestyles • Children who met neither recommendation had an increased risk of health complaints compared to those who met both recommendations • Our findings suggest that TST may be a stronger determinant of health complaints than physical activity – thus targeting TST may be particularly important for policy and practice
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  ACKNOWLEDGEMENTS We would liketo acknowledge our funders, the Department of health in Ireland, the children who participated and their parents, the management authorities, principals and teachers of participating schools, the staff at the Health Promotion Research Centre, NUIG and the HBSC Ireland Advisory Board. The International co-ordinator of HBSC is Dr Jo Inchley, University of St Andrews and Professor Oddrun Samdal, University of Bergen is the databank manager HBSC is an international alliance of over 400 adolescent health experts based in 44 countries who collaborate to develop and execute the HBSC survey Every 4 years, the HBSC network collects data on 11, 13 and 15 year olds’ health and well-being, social environments and health behaviours The 2014 international dataset includes 219,810 students MY CONTACT DETAILS: eimear.keane@ nuigalway.ie @EKeaneNUIG