De Cocker, Katrien and Artero, Enrique G. and De Henauw, Stefaan and Dietrich, Sabine and Gottrand, Frederic and Beghin, Laurent and Hagstromer, Maria and Sjostrom, Michael and Plada, Maria and Manios, Yannis and Mauro, Beatrice and Molnar, Denes and Moreno, Luis A. and Ottevaere, Charlene and Valtuena, Jara and Maes, Lea and De Bourdeaudhuij, Ilse (2012) Can differences in physical activity by socio-economic status in European adolescents be explained by differences in psychosocial correlates? A mediation analysis within the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Public Health Nutrition, 15 (11). pp. 2100-2109. ISSN 1368-9800
Abstract
OBJECTIVE: Socio-economic status (SES) has been positively associated with physical activity (PA) levels in adolescents. In order to tackle these social inequalities, information is needed about the underlying mechanisms of this association. The present study aimed to investigate the potential mediating role of psychosocial correlates of PA on the relationship between SES and PA in European adolescents.
DESIGN: Cross-sectional study testing the mediating role of psychosocial correlates in the SES-PA association using the product-of-coefficients test of MacKinnon.
SETTING: Ten European cities in nine different countries, the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study.
SUBJECTS: Adolescents (n 2780) aged 12.5-17.49 years self-reported on PA (moderate-to-vigorous intensity PA and total PA), SES indicators (education of the mother and Family Affluence Scale) and psychosocial correlates of PA (stage of change, attitudes, awareness, modelling, social support, self-efficacy, benefits, barriers and environmental correlates).
RESULTS: SES (Family Affluence Scale) was significantly associated with moderate-to-vigorous intensity PA. According to single-mediator models, this association was significantly mediated by stage of change (t = 3.6, P </= 0.001), awareness (t = 2.7, 0.001 < P </= 0.01), modelling (t = 4.8, P </= 0.001), self-efficacy (t = 2.5, 0.01<P </= 0.05), barriers (t = 2.7, 0.001 < P </= 0.01) and environmental (t = 3.0, 0.001 < P </= 0.01) correlates of PA. The multiple-mediators model showed that the mediating role of the combination of these psychosocial correlates was also significant (t = 6.2, P </= 0.001).
CONCLUSIONS: Adolescents with low family wealth scored lower on stage of change, awareness, modelling, self-efficacy and environmental correlates of PA, and higher on PA barriers, which in turn resulted in lower levels of moderate-to-vigorous PA. Future interventions should target these individual and environmental constructs in order to tackle and intervene on social inequalities in PA among adolescents.
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