Background: Insufficient physical activity (PA) in the youth can lead to adverse health outcomes, and youth in rural areas have particularly low PA. However, factors contributing to these levels remain unclear. Using data from a middle school-based wellness intervention called Motivating Adolescents with Technology to Choose HealthTM (MATCH), we evaluated demographic and environmental factors predicting PA in adolescents across rural North Carolina.

Methods: We used cross sectional data from MATCH participants in 40 schools from fall 2018. Self-reported PA was determined from a validated question: “How many days each week are you active for at least 60 minutes?,” with results dichotomized into those achieving 1, 5 and 7 day(s) meeting the threshold. Other variables included sex, race, weight category determined from Body Mass Index percentile, and PACER score (measuring cardiovascular fitness). Three environmental variables, from a previous study, were scored for each school from 1-5 (higher = better environment) (Table 1). Analyses included appropriate measures of descriptive statistics (mean, t test, Chi Square), correlation (Pearson, Spearman), and regression models.

Results: Participants included 3,799 7th graders, approximately half male, half white, mean age of 12.7 years, and 27.8% obese. Male sex (p = <.0001), white (p = <.0001), and healthy weight (p = <.0001) participants reported more days PA (Table 2). Associations between the environmental variables and self-reported PA yielded statistically significant but extremely weak (|r| ≤0.1) relationships; however, school PE and PACER (r=.27, p <.0001) were correlated. Regression models showed significant independent relationships of self-reported PA and school PE (B= .108, p = .0011) and race (B= -.306 , p = .0005).

Conclusion: Adolescents in rural NC report low PA, but more is reported by male, white and healthy weight participants. School PE may increase student PA. Studies are warranted evaluating PA differences by race and sex.

Table 1
Table 2