Socioeconomic Correlates of Sedentary Behavior in Adolescents: Systematic Review and Meta-Analysis - PubMed (original) (raw)

Socioeconomic Correlates of Sedentary Behavior in Adolescents: Systematic Review and Meta-Analysis

Gregore I Mielke et al. Sports Med. 2017 Jan.

Abstract

Background: The body of evidence on associations between socioeconomic status (SES) and sedentary behaviors in adolescents is growing.

Objectives: The overall aims of our study were to conduct a systematic review and meta-analysis of this evidence and to assess whether (1) the associations between SES and sedentary behavior are consistent in adolescents from low-middle-income and from high-income countries, (2) the associations vary by domain of sedentary behavior, and (3) the associations vary by SES measure.

Methods: We performed a systematic literature search to identify population-based studies that investigated the association between SES and sedentary behavior in adolescents (aged 10-19 years). Only studies that presented risk estimates were included. We conducted meta-analyses using random effects and univariate meta-regression and calculated pooled effect sizes (ES).

Results: Data from 39 studies were included; this provided 106 independent estimates for meta-analyses. Overall, there was an inverse association between SES and sedentary behavior (ES 0.89; 95 % confidence interval [CI] 0.81-0.98). However, the direction of the association varied: in high-income countries, SES was inversely associated with sedentary behavior (ES 0.67; 95 % CI 0.62-0.73), whereas in low-middle-income countries, there was a positive association between SES and sedentary behavior (ES 1.18; 95 % CI 1.04-1.34). In high-income countries, the associations were strongest for screen time (ES 0.68; 95 % CI 0.62-0.74) and television (TV) time (ES 0.58; 95 % CI 0.49-0.69), whereas in low-middle-income countries, the associations were strongest for 'other' screen time (i.e., computer, video, study time, but not including TV time) (ES 1.38; 95 % CI 1.07-1.79). All indicators of SES were negatively associated with sedentary behavior in high-income countries, but only resources (income and assets indexes) showed a significant positive association in low-middle-income countries.

Conclusion: The associations between SES and sedentary behavior are different in high- and low-middle-income countries, and vary by domain of sedentary behavior. These findings suggest that different approaches may be required when developing intervention strategies for reducing sedentary behavior in adolescents in different parts of the world.

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Conflict of interest statement

Compliance with Ethical Standards Funding Gregore Mielke was funded by a scholarship from the Coordinator for the Improvement of Higher Education Personnel (CAPES), Brazil. This work was supported by a partnership between CAPES, Federal University of Pelotas, Brazil, and the School of Human Movement and Nutrition Sciences, University of Queensland, Australia, that enabled international collaborative work to be undertaken. Conflict of interest Gregore Mielke, Wendy Brown, Bruno Nunes, Inacio Silva, and Pedro Hallal have no conflicts of interest relevant to the content of this review.

Figures

Fig. 1

Fig. 1

Flowchart reporting the process for selection of papers for inclusion in the meta-analysis. SB sedentary behavior, SES socioeconomic status

Fig. 2

Fig. 2

General meta-analysis of the association between socioeconomic status and sedentary behavior. AI assets index, CI confidence interval, ES effect size, FE paternal education, FO paternal occupation, I income, ME maternal education, MO maternal occupation, PC computer, PE parental education, PO parental occupation, SB sedentary behavior, SES socioeconomic status, TV television, VG video game. TV + indicates estimates based on studies that measure sedentary behavior as: a TV + VG or b TV + PC

Fig. 3

Fig. 3

Meta-analysis of the association between socioeconomic status and high screen-based time. AI assets index, CI confidence interval, ES effect size, FE paternal education, I income, ME maternal education, PE parental education, PO parental occupation, SB sedentary behavior, SES socioeconomic status

Fig. 4

Fig. 4

Meta-analysis of the association between SES and high television viewing time. AI assets index, CI confidence interval, ES effect size, FE paternal education, FO paternal occupation, I income, ME Maternal education, MO maternal occupation, PE parental education, PO parental occupation, SB sedentary behavior, SES socioeconomic status

Fig. 5

Fig. 5

Meta-analysis of the association between socioeconomic status and other sedentary behavior domains (computer, video game, study time, but not including TV time). AI assets index, CI confidence interval, ES effect size, FE paternal education, FO paternal occupation, I income, ME maternal education, MO maternal occupation, PC computer, PE parental education, SB sedentary behavior, SES socioeconomic status, VG video game

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