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Background: Young people spend half of their days in school, but evidence concerning the influence of school environment on the physical activity (PA) of pupils is still inconsistent. A better understanding of potential correlates of PA on the school-level and their possible interaction with individual aspects is needed to improve the development of more effective interventions. Methods: We used data from the 2009/10 German Health Behaviour in School-aged Children study (HBSC)-sample (n=5,005 students aged 11-15 years) including self-reported moderate to vigorous intensity PA as well as a variety of biological, demographic and behavioral correlates and matched them with school-level data from the national school principals' HBSC questionnaire. We analyzed the associations of individual- and school-level correlates with MVPA by gender-specific multi-level regression. Results: Only a small share of the overall variation in student's PA was attributable to the school-level. Consequently, the associations of individual-level correlates with PA were stronger than those of the school-level. Our analysis revealed significant associations of individual-level (i.e. age, consumption of softdrinks, overweight) as well as school-level correlates (i.e. the availability of a football ground and a swimming pool) with MVPA. We also observed some gender-specific findings especially for the school level correlates. Cross-level interactions between individual- and school-level were not apparent. Conclusions: Our findings indicate the usefulness of applying an ecological framework to understand and explain complex health behaviors like PA. As we found gender-specific association it might be important to acknowledge that boys and girls have specific needs to be more physically active. Further research should also take other features/elements of the school environment and neighborhood as well as socio-cognitive correlates into account to advance the field. [ABSTRACT FROM AUTHOR]

Background Studies in youth highlight that moderate-to-vigorous physical activity (MVPA) and screentime behaviours such as television viewing and PC use are associated with a range of health outcomes. However, little is known about recent trends in these behaviours in adolescents. This paper presents time trends in German adolescents' television time, non-gaming PC use as well as MVPA from 2002 to 2010. Methods Data were derived from the cross-sectional German Health Behaviour in School-aged Children (HBSC) study in 2002, 2006 and 2010. Analyses were based on 16,918 11-to 15- year olds boys (49.1%) and girls. Outcome variables were time spent in TV viewing and using a PC (weekday and weekend day) as well as the number of days achieving 60 minutes of MVPA. Changes in both screen-time behaviours and MVPA over time were analysed using sex-specific linear regression, controlling for age and family affluence. Results TV viewing on weekdays, but not at weekends, declined steadily over time with a difference between 2002 and 2010 of 12.4 min/day in girls and 18.3 min/day in boys (p for trend < .01). We found a strong increase in PC use for non-gaming purposes over time for girls only, with a difference between 2002 and 2010 of 54.1 min/weekday and 68.8 min/weekend day (p < .001). For MVPA we found a slight statistically significant increase in terms of meeting PA guidelines as well as days/week in MVPA for boys and girls (p < .001). In 2010 14.0% of girls and 19.9% of boys met PA guideline. Conclusion Although MVPA increased from 2002 to 2010 in German adolescents, the time spent in MVPA was still low. Despite the observed decrease in TV viewing, there was no overall decline in the observed screen-based behaviours, especially for girls. This is mainly due to a marked increase in use of a PC for chatting on-line, internet, emailing, homework etc. among girls during the last ten years which outweighs the corresponding decrease in TV viewing. The findings highlight a need for strategies and interventions aimed at reducing screen-time behaviours and promoting MVPA. [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life (HRQoL) is reduced in obese children and adolescents, especially in clinical samples. However, little is known regarding the HRQoL of moderately overweight youth. Moreover, several studies have indicated perceived overweight as a critical factor associated with lower HRQoL. Our main objective was to compare HRQoL between treatment-seeking overweight youth and the general adolescent population, whilst separating the effects of treatment-seeking status and perceived weight from those of objective weight status. Methods:We compared the HRQoL of a clinical sample of overweight youth (N=137 patients, mean age±s.e.=11.24±0.15 years) with that of a representative population sample (N=6354, mean age=12.75±0.03 years). The population sample was subdivided into groups based on measured and perceived weight status. We used hierarchical linear models to compare HRQoL subscale scores (self- and parent-reported) between patients and population groups, adjusted for sociodemographic characteristics and taking into account clustering of the population sample. Results: The parent-reported HRQoL of the treatment sample was significantly lower than that of other overweight youth perceived as 'too fat' on two subscales: 'self-esteem' and 'friends' (effect sizes: d=0.31 and 0.34, respectively). On other subscales, patients scored lower than adolescents perceived as having a 'proper weight' by their parents. The patterns for self-reported HRQoL in adolescents were different: patients reported higher self-esteem than other overweight youth feeling 'too fat' (d=-0.39). Female patients also reported higher physical well-being (d=-0.48), whereas males scored lowest among all compared groups (d=0.42-0.95). Patients did not differ from other overweight youth who felt 'too fat' with respect to other HRQoL dimensions. In general, lower HRQoL was primarily associated with a perceived, rather than actual, overweight status. Conclusions: The treatment-seeking status of overweight youth was notably associated with low social well-being, which may therefore be the main motive for seeking treatment. Other HRQoL domains were not consistently reduced in treatment-seekers. Our results further indicate that perceived overweight rather than actual overweight impacts HRQoL in youth with a modest excess weight. These results have implications for interventions in overweight youth and in individuals who are dissatisfied with their weight. Trial registration: 'Obeldicks light' is registered at clinicaltrials.gov (NCT00422916). [ABSTRACT FROM AUTHOR]

Background: Health-related quality of life (HRQoL) was found to improve in participants of weight management interventions. However, information on moderately overweight youth as well as on maintaining HRQoL improvements following treatment is sparse. We studied the HRQoL of 74 overweight, but not obese participants (32.4% male, mean age = 11.61 ± 1.70 SD) of a comprehensive and effective six-month outpatient training at four time-points up to 12 months after end of treatment. Methods: HRQoL was measured by self-report and proxy-report versions of the generic German KINDL-R, including six sub domains, and an obesity-specific additional module. Changes in original and z-standardized scores were analyzed by (2×4) doubly multivariate analysis of variance. This was done separately for self- and proxy-reported HRQoL, taking into account further socio-demographic background variables and social desirability. Additionally, correlations between changes in HRQoL scores and changes in zBMI were examined. Results: There were significant multivariate time effects for self-reported and proxy-reported HRQoL and a significant time-gender interaction in self-reports revealed (p < .05). Improvements in weight-specific HRQoL were evident during treatment (partial η2 = 0.14-0.19). Generic HRQoL further increased after end of treatment. The largest effects were found on the dimension self-esteem (partial η2 = 0.08-0.09 for proxy and self-reported z-scores, respectively). Correlations with changes in weight were gender-specific, and weight reduction was only associated with HRQoL improvements in girls. Conclusions: Positive effects of outpatient training on generic and weight specific HRQoL of moderately overweight (not obese) children and adolescents could be demonstrated. Improvements in HRQoL were not consistently bound to weight reduction. While changes in weight specific HRQoL were more immediate, generic HRQoL further increased after treatment ended. An extended follow-up may therefore be needed to scrutinize HRQoL improvements due to weight management. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) shows a marked decline during adolescence. Some studies have pointed to pubertal status or timing as possible PA determinants in this age group. Furthermore, it was supposed that the impact of pubertal changes on PA might be mediated by psychological variables like body dissatisfaction (BDS)., Methods: The 11- to 17-year-old subsample of the German Health Interview and Examination Survey (KiGGS) was used (n = 6 813; 51.3% male, response rate = 66.6%). Through sex-specific sequential multinomial logistic regressions we analysed the univariate and independent associations of chronological age, absolute pubertal status, relative pubertal timing, and BDS with the frequency of PA., Results: Chronological age showed a significantly negative association with PA in both sexes, independent of puberty. The odds of inactivity in contrast to nearly daily PA increased about 70% in boys and 35% in girls for each year of age, respectively. Adjusted for age and other possible confounders, inactivity was significantly less likely for boys in late pubertal stages (OR = 0.27, 95% CI = 0.09-0.78). The risk of inactivity was more than doubled in boys maturing earlier than peers in terms of relative pubertal timing (OR = 2.20, 95% CI = 1.36-3.56). No clear significant puberty effects were found in girls, but the inactivity was more likely for those with irregular menstruation (OR = 1.71, 95% CI = 1.06-2.75). BDS also contributed to the prediction of PA in both sexes. It partially mediated puberty effects in boys but not in girls., Conclusions: Overall, chronological age was a far more important predictor of PA in German adolescents than absolute pubertal status or relative pubertal timing. Further possible explanatory variables like sociocultural influences, social support or increasing time requirements for education should be analysed in conjunction with chronological age in future studies.