Lu Congchao, Stolk Ronald P, Sauer Pieter J J, Sijtsma Anna, Wiersma Rikstje, Huang Guowei, Corpeleijn Eva
Department of Epidemiology (HPC FA40), University Medical Centre Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
School of Public Health, Tianjin Medical University, Tianjin, China.
Int J Behav Nutr Phys Act. 2017 Mar 21;14(1):36. doi: 10.1186/s12966-017-0486-y.
Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development.
A systematic search was finished on Jan 10, 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method.
Forty two papers (published 2002-2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents' physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents.
The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood.
由于过去二十年经济的快速发展和生活环境的变化，身体活动不足在中国正成为一个日益严重的问题。本综述的目的是总结在中国儿童和青少年这一独特发育阶段与身体活动相关的因素。
于2017年1月10日完成系统检索，通过PubMed和Web of Science共识别出2200条结果。纳入报告了因素与身体活动之间统计关联的英文发表研究。采用流行病学观察性研究报告强化（STROBE）声明中的改编标准以及系统评价中预后研究质量评估（QUIPS）来评估纳入研究的偏倚风险。使用半定量方法分别总结了儿童和青少年中至少三项研究报告的相关因素。
纳入42篇论文（发表于2002 - 2016年）。大多数研究设计为横断面研究（79%），且大多数研究使用问卷来评估身体活动。18篇论文（43%）的样本量超过1000。37项研究（88%）经方法学质量评估显示质量可接受。大多数研究报告身体活动水平较低。男孩的活动量始终高于女孩，父母的身体活动与儿童和青少年的身体活动呈正相关，城郊/农村地区的儿童活动量低于城市地区，且具体在青少年中，自我效能与身体活动呈正相关。家庭社会经济地位和父母教育程度与儿童和青少年的身体活动无关。
本综述纳入的研究规模较大，但在研究设计（横断面研究）和方法（问卷）方面大多质量较低。父母的身体活动和自我效能是未来身体活动促进项目有前景的目标。身体活动水平较低令人担忧，尤其是在城郊/农村地区。需要进一步研究以增进我们对其他影响因素的理解，如物理环境，特别是在幼儿期。
