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Int.J. Behav. Med.

(2010) 17:279286
DOI 10.1007/s12529-009-9060-6

Determinants of Physical Activity in Singaporean


Adolescents
Kok Sonk Lee & Paul D. Loprinzi & Stewart G. Trost

Published online: 4 September 2009


# International Society of Behavioral Medicine 2009

Abstract appropriate physical activity options that promote mastery


Background An understanding of the factors that influence and adopt policies that increase parental support and
physical activity behavior is an important prerequisite for the awareness of community physical activity programs.
design and implementation of physical activity interventions in
adolescents. To date, no studies have investigated the factors Keywords Exercise . Youth . Health promotion .
that influence physical activity participation in Singaporean Self-efficacy . Enjoyment
adolescents.
Purpose The purpose of this study was to identify the
psychosocial and environmental factors that influence physical Introduction
activity in a representative sample of Singaporean adolescents
(N=1,814, 919 boys, 895 girls, mean age 14.41.1 years). Chronic diseases such as cancer, coronary heart disease,
Methods Participants completed the Three-Day Physical and stroke are the leading causes of death in Singapore
Activity Recall and a questionnaire measuring hypothesized today [1]. In 2000, these three conditions accounted for
psychosocial and environmental correlates of physical approximately 60% of all deaths in Singapore [1]. Regular
activity. participation in physical activity is associated with a
Results Hierarchical regression revealed self-efficacy, en- number of positive health outcomes. Among adults, regular
joyment of physical activity, parental support, and partic- physical activity reduces the risk of many chronic diseases,
ipation in sport teams to be significant correlates of including coronary heart disease, hypertension, stroke,
physical activity. depression, type 2 diabetes, and certain cancers [2]. The
Conclusion Interventions promoting physical activity in evidence linking physical activity and health outcomes in
Singaporean adolescents should aim to increase self- children and adolescents is less consistent. Emerging
efficacy perceptions by offering enjoyable, developmentally evidence suggests that physical activity has beneficial
effects on weight status, blood lipids and lipoproteins, bone
K. S. Lee health, and psychological well-being [3, 4]. Moreover,
School of Human Movement Studies, because several health outcomes associated with physical
The University of Queensland, activity track from childhood into adulthood, regular
Brisbane, Queensland 4072, Australia
physical activity may be important in the prevention of
e-mail: LEE_Kok_Sonk@moe.gov.sg
chronic diseases later in life [5, 6].
P. D. Loprinzi : S. G. Trost (*) Despite the health benefits of physical activity, Singaporean
Department of Nutrition and Exercise Sciences, adolescents are not participating in physical activity on a
Oregon State University,
regular basis. The results of a recent national study indicate
203D Womens Building,
Corvallis, OR 97331, USA that significant percentages of Singaporean high school
e-mail: stewart.trost@oregonstate.edu students do not meet public health guidelines for physical
P. D. Loprinzi activity. Currently, 37% of Singaporean adolescents fail to
e-mail: loprinzp@onid.orst.edu meet the current physical activity guideline of 60 min of
280 Int.J. Behav. Med. (2010) 17:279286

daily moderate to vigorous physical activity (MVPA), and was approved by the University of Queensland Medical
approximately 50% report no participation in vigorous Research Ethics Committee and the Ministry of Education,
physical activity on a daily basis [7]. On average, girls Singapore.
participate in 20% less daily MVPA than boys [7].
Although the percentage of Singaporean adolescents meet- Measurement of Physical Activity
ing the 60-min MVPA guideline (63%) is somewhat higher
than that reported for high school students in the USA Physical activity was assessed using Three-Day Physical
(34%) [8] and 1315 year olds participating in the World Activity Recall (3DPAR). This instrument requires students
Health Organizations 20012002 Health Behavior in to recall their past physical activity behavior from each of
School-Aged Children survey (34%) [9], the observed low the three previous days, beginning with the most recent day.
prevalence of sustained vigorous physical activity and the Each day is segmented into 30-min time blocks (7:00 a.m.
marked gender differences in MVPA underscore the need to midnight), which, in turn, are grouped into broader time
for effective physical activity intervention programs for this periods such as morning, afternoon, and evening. The
population. instrument provides a list of 53 commonly performed
An important prerequisite to designing and implement- activities grouped into the following categories: sleep/
ing physical activity intervention programs is to understand bathing, eating, work, interschool/spare time/hobbies,
the factors that influence physical activity. Several compre- transportation, and physical activities/sports. For each block
hensive reviews on the correlates of physical activity in of each day, the student entered the main activity for which
youth have identified physical activity self-efficacy, beliefs they participated during that 30-min period. The main
about physical activity, attitude towards physical activity, activity was defined as the activity that occupied the
social norms, enjoyment of physical activity, parental majority of the 30-min period. Participants also rated the
support, sport equipment at home/access to equipment and relative intensity of the designated activity as light,
facilities, supervised school sports, and participation in medium, hard, or very hard. To help participants select
sports teams as significant influences on physical activity the correct intensity level, the instrument provides pictorial
behavior [2, 10, 11]. However, because the majority of representation of four levels of relative intensity.
studies included in these reviews were conducted in the All students completed the 3DPAR instrument on a
western countries such as the USA, it is uncertain whether Wednesday, recalling activities from the immediate preced-
these findings can be generalized to Singaporean adoles- ing Tuesday, Monday, and Sunday. Each 30-min block on
cents. Currently, we are aware of no studies that have the 3DPAR instrument was assigned a literature-based
investigated the correlates of physical activity in a sample metabolic equivalent (MET) task value based on the
of Singaporean adolescents. To address this research gap, reported activity and level of intensity [12]. MET values
the purpose of this study was to identify the psychosocial from all 34 blocks were then averaged to derive an estimate
and environmental correlates of physical activity behavior of mean activity level during each day. The 3DPAR was
in Singaporean high school students aged 13 to 16 years. customized to include activities typically performed by
Singaporean adolescents and has shown to be reliable and
valid in Singaporean youth [13].
Materials and Methods
Correlates of Physical Activity
Participants and Settings
Students completed a questionnaire designed to measure
A stratified two-stage cluster sample design was used to hypothesized demographic, psychosocial, and environmen-
select a representative sample of Singaporean adolescents. tal correlates of physical activity. Variables were selected on
The first stage involved the random selection of six schools the basis of Social Cognitive Theory [14] and the Theory of
from each geographical region, and the second stage Reasoned Action/ Planned Behavior [15]. A brief descrip-
involved selecting two classes per level in each school. tion of these scales, the number of items, possible range of
All 1,902 students (100%) from the randomly selected class scores, testretest reliability coefficients, internal consisten-
groups agreed to participate in the study. After deletions for cy statistics (Cronbachs alpha) are provided in Table 1.
incomplete or missing data, the final sample consisted of The measures of physical activity self-efficacy, attitude
1,814 students (95.4%). The demographic characteristics towards physical activity, and social norms regarding
of the initial and final sample remained unchanged by physical activity were modeled on the measurement scales
the exclusion of these students. Prior to participation in the developed by Saunders and coworkers [16]. The self-
study, written informed consent was obtained from efficacy measure consisted of eight items rated on a five-
the principal of each school and the students. This study point Likert-type scale anchored by 1 (strongly disagree)
Int.J. Behav. Med. (2010) 17:279286 281

Table 1 Description of scales used to measure correlates of physical activity

Name of scale No. of Range of possible Testretest Cronbachs Sample questions


items scores alpha

Self-efficacy 8 15 0.89 0.80 I can be physically active during


my free time on most days
Attitude 8 (125) 0.88 0.78 If I were to be physically active during
my free time on most days...
It would be fun Having fun is...
Social norms 8 (125) 0.73 0.88 My fellow students think I should be
physically active during my free time
on most days I want to do what
my fellow students want me to do
Parental support 5 (04) 0.94 0.82 During a typical week, how often has
your parent encouraged you to do
physical activity or sports?
Sport equipment at home 1 (15) 0.86 NA At home there are enough supplies and
pieces of sports equipment (e.g., balls,
bicycles, skates) to use for physical activity
Access to facilities 1 (15) 0.89 NA There are playgrounds, parks, or gyms close
to my home that I can get to easily
Neighborhood safety 1 (15) 0.78 NA It is safe to walk or jog alone in my
neighborhood during the day
Perceived walkability 1 (15) 0.73 NA It is difficult to walk or jog in my
neighborhood because of things like traffic,
no sidewalks, dogs, or gangs
School activity programs 3 (01) 0.83 0.61 At your school, are there supervised physical
activity programs (e.g., mass walking,
mass jogging) for all interested students?
Participation in sports teams 2 (03) 0.97 0.59 During the past 12 months, how many sports
teams run by your school did you play on?
Enjoyment of physical activity 14 (15) 0.90 0.91 When I am active ... I enjoy it

NA not applicable

to 5 (strongly agree). The attitude measure included eight disagree). Scores for enjoyment of physical activity were
items that consisted of belief and corresponding value computed by averaging the responses to each item.
statements. The belief statements were rated also on a five- Hypothesized physical and social environmental corre-
point Likert-type scale anchored by 1 (strongly disagree) lates included items designed to measure parental support,
to 5 (strongly agree); value statements were rated on a five- sporting/fitness equipment at home, access to sports/fitness
point Likert-type scale with responses ranging from 1 (very facilities, perceived neighborhood walkability, perception of
bad) to 5 (very good). Attitude scores were computed by neighborhood safety, availability of supervised school
multiplying the response for each belief statement with its sports, and participation in sport teams. These items were
corresponding value response and averaging the products. modified from measures used in the National Children and
The social norms measure included eight items that consisted Youth Fitness Study [18] and the CDC Youth Risk Behavior
of normative beliefs and corresponding motivation to Survey [19]. When any of these measures consisted of
comply statements. Normative belief statements and moti- multiple items, scores were computed by averaging the
vation to comply statements were rated on five-point Likert- responses to each item. The psychometric properties of
type scales anchored by 1 (strongly disagree) and 5 these measures have been reported elsewhere [20, 21].
(strongly agree). Social norms scores were computed by
averaging by the product of each normative belief and Study Protocol
motivation to comply rating. The enjoyment of physical
activity measure was modeled on the 14-item scale devel- Data were collected during two classroom visits completed
oped by Motl and colleagues [17]. Responses to each item within a single week. Students completed the 3DPAR
were reported on a five-point Likert-type scale with end during the first visit and the correlates of physical activity
points ranging from 1 (strongly agree) to 5 (strongly questionnaire during the second visit. Each instrument took
282 Int.J. Behav. Med. (2010) 17:279286

Table 2 Gender differences in


mean METs and correlates of Variable Boys (n=919) Girls (n=895)
physical activity in Singaporean Mean (95% CI) Mean (95% CI)
adolescents
Activity
Mean METs 1.98 (1.942.02) 1.83 (1.801.85)*
Correlates
Self-efficacy 3.38 (3.313.45) 3.26 (3.233.29)*
Attitude 15.87 (15.3916.35) 15.52 (15.2515.78)
Social norms 11.20 (10.7311.67) 10.31 (9.9410.67)*
Enjoyment of physical activity 3.95 (3.884.02) 3.85 (3.813.90)
Parental support 0.95 (0.851.06) 0.99 (0.811.18)
Sport equipment at home 3.49 (3.363.62) 3.36 (3.243.48)
Access to facilities 3.61 (3.553.67) 3.75 (3.673.82)
Neighborhood Safety 3.86 (3.724.01) 3.67 (3.493.85)
Perceived walkability 2.49 (2.392.59) 2.48 (2.302.65)
School activity programs (%) 51.6 (48.854.4) 53.5 (49.957.1)
*p<0.05, denotes significant Participation in sports teams (%) 61.8 (57.466.2) 61.1 (57.265.0)
difference from boys

approximately 30 to 45 min to complete. Prior to data to sports, safety concerns, availability of supervised school
collection, both instruments were piloted to ensure that the sports, and participation in sports teams were significant
reading level and response format were appropriate for positive correlates of physical activity. Correlations ranged
Singaporean adolescents. from 0.06 for social norms to 0.26 for self-efficacy. For
girls, self-efficacy, attitude, social norms, enjoyment of
Statistical Analysis physical activity, parental support, sport equipment at
home, access to sports, neighborhood safety, and participa-
All data were analyzed using STATA, version 7.0. tion in sports teams were significant positive correlates of
Descriptive statistics were calculated for mean MET levels physical activity. Correlations ranged from 0.07 for access
and physical activity correlate variables. Due to positively to sports to 0.20 for parental support. Low perceptions of
skewed data, mean METs was log-transformed. Crude neighborhood walkability exhibited a weak but significant
associations between mean METs and the hypothesized inverse correlation with physical activity behavior.
correlates of physical activity were assessed using Pearson Table 4 presents the results of the hierarchical regression
productmoment correlation coefficients. Hierarchical line- analysis for boys. On step 1, the demographic influences of
ar regression analysis was conducted to determine whether race, grade level, and socioeconomic status accounted for
the demographic, psychological, and environment variables
exhibiting significant univariate relationships were inde-
pendently associated with participation in physical activity. Table 3 Correlation coefficients between mean METs and correlates
Analyses were performed separately for boys and girls. of physical activity in Singaporean adolescents
Significance was set at an alpha level of 0.05.
Variable Boys (n=919) Girls (n=895)

Self-efficacy 0.26*** 0.18***


Results Attitude 0.21*** 0.18***
Social norms 0.06* 0.08*
Descriptive statistics for the physical activity and correlate Enjoyment of physical activity 0.23*** 0.19***
variables are presented in Table 2. On average, boys Parental support 0.15** 0.20***
reported significantly higher mean MET scores than girls. Sport equipment at home 0.15*** 0.17***
Boys also scored significantly higher than girls on the self- Access to facilities 0.07* 0.07*
efficacy and social norms scales. No significant gender Neighborhood safety 0.08** 0.10**
differences were observed for the remaining variables. Perceived walkability 0.03 0.06**
Simple correlations between physical activity and the
School activity programs 0.14*** 0.05
hypothesized correlates are shown in Table 3. For boys,
Participation in sports teams 0.17*** 0.14***
self-efficacy, attitude, social norms, enjoyment of physical
activity, parental support, sport equipment at home, access *p<0.05; **p<0.01; ***p<0.001
Int.J. Behav. Med. (2010) 17:279286 283

Table 4 Hierarchical regression


analyses for the prediction of Variables b SE (b) Std beta Adj R2 Model R2
log mean METS among
Singaporean adolescent boys Step 1
(N=919) Race* 0.013 0.004 0.101 0.008 0.012
Grade level 0.005 0.006 0.030
Socio economic status (SES) 0.004 0.006 0.022
Step 2
Race* 0.009 0.004 0.068 0.082 0.089
Grade 0.006 0.006 0.034
Socio economic status (SES) 0.001 0.006 0.004
Self-efficacy* 0.025 0.005 0.187
Attitude 0.001 0.001 0.055
Social norms 0.001 0.001 0.066
Enjoyment of physical activity* 0.017 0.062 0.114
Step 3
Race 0.006 0.004 0.047 0.098 0.111
Grade 0.004 0.006 0.020
Socio economic status (SES) 0.002 0.006 0.011
Self-efficacy* 0.020 0.005 0.154
Attitude 0.001 0.001 0.048
Social norms 0.002 0.001 0.086
Enjoyment of physical activity* 0.014 0.006 0.098
Parental support* 0.009 0.004 0.079
Sport equipment at home 0.004 0.003 0.054
Access to facilities 0.002 0.003 0.020
Neighborhood safety 0.002 0.003 0.024
School activity programs 0.011 0.006 0.062
Participation in sports teams* 0.015 0.006 0.078
*p<0.05, denotes significance

only 1% of the variance with physical activity (F(3, 914)= step 2, it significantly increased the predictive power of the
3.57, p=0.014), with race being the only significant model (incremental F(4, 887)=10.91, p<0.0001), account-
independent predictor. When self-efficacy, attitude, social ing for an additional 4% of the variance in physical activity.
norms, and enjoyment of physical activity were entered on Of the four psychological variables entered, self-efficacy
step 2, it significantly increased the predictive power of the and enjoyment of physical activity emerged as significant
model (incremental F(4, 911)=19.46, p<0.0001), account- independent predictors. The addition of the environmental
ing for an additional 7% of the variance in physical activity. influences on step 3 significantly enhanced the prediction
Of the four psychological variables entered, self-efficacy of the physical activity (incremental F(6, 881)=5.91, p<
and enjoyment of physical activity emerged as significant 0.0001), accounting for an additional 3% of the variance.
independent predictors. The addition of the environmental Of the six variables entered, parental support, sports
influences on step 3 significantly enhanced the prediction equipment at home, and participation in sport teams
of the physical activity (incremental F(6, 905)=3.15, p< emerged as significant independent predictors.
0.0001), accounting for an additional 2% of the variance.
Of the six variables entered, parental support and partici-
pation in sport teams emerged as significant independent Discussion
predictors.
Table 5 presents the results of the hierarchical regression The purpose of this study was to identify the correlates of
analysis for girls. On step 1, the demographic influences of physical activity in a representative sample of Singaporean
race, grade level, and socioeconomic status accounted for adolescents. Our key finding was that self-efficacy, enjoyment
only 1% of the variance with physical activity (F(3, 889)= of physical activity, parental support for physical activity, and
0.88, p=0.009), with race being the only significant involvement in school sports programs were associated with
independent predictor. When self-efficacy, attitude, social physical activity behavior in both adolescent boys and girls. In
norms, and enjoyment of physical activity were entered on all cases, the associations were in the expected direction.
284 Int.J. Behav. Med. (2010) 17:279286

Table 5 Hierarchical regression


analyses for the prediction of Variables b SE (b) Std beta Adj R2 Model R2
log mean METS among
Singaporean adolescent girls Step 1
(N=895) Race* 0.008 0.003 0.093 0.010 0.013
Grade level 0.006 0.005 0.044
Socio economic status (SES) 0.008 0.005 0.052
Step 2
Race* 0.006 0.003 0.076 0.052 0.059
Grade 0.004 0.005 0.032
Socio economic status (SES) 0.007 0.005 0.049
Self-efficacy* 0.012 0.004 0.105
Attitude 0.001 0.010 0.049
Social norms 0.000 0.001 0.010
Enjoyment of physical activity* 0.012 0.005 0.106
Step 3
Race 0.004 0.003 0.045 0.082 0.096
Grade 0.003 0.005 0.019
Socio economic status (SES) 0.001 0.005 0.004
Self-efficacy* 0.008 0.004 0.070
Attitude 0.001 0.001 0.037
Social norms 0.000 0.001 0.025
Enjoyment of physical activity* 0.010 0.005 0.082
Parental support* 0.011 0.003 0.129
Sport equipment at home* 0.006 0.002 0.090
Access to facilities 0.017 0.003 0.025
Neighborhood safety 0.004 0.003 0.049
Perceived walkability 0.002 0.005 0.032
Participation in sports teams* 0.012 0.005 0.083
*p<0.05, denotes significant

An important finding was that self-efficacy was posi- the participation of physical activity by reducing or
tively associated with physical activity in both boys and eliminating competitions and inappropriate testing practices.
girls. Our results are consistent with previous studies, Enjoyment of physical activity has long been considered an
showing that self-efficacy is an important intrapersonal important influence on physical activity. Consistent with
influence on physical activity behavior [10]. Bungum and results from previous investigations [22, 24, 25], enjoyment
colleagues [22] found self-efficacy to be a key correlate of of physical activity was positively associated with physical
physical activity behavior in both male and female youth. activity behavior in both boys and girls. Interventions
Similarly, Allison and colleagues [23] reported self-efficacy directed at Singaporean adolescents should aim to promote
to be positively associated with participation in vigorous enjoyment of physical activity by offering a wide variety of
physical activity in Canadian high school students. In traditional and nontraditional physical activity options that
accordance with the major tenets of Social Cognitive meet their needs and interests of students. Examples of
Theory [14], self-efficacy perceptions can be derived from traditional physical activity options include team and
past performances, vicarious experiences (modeling), ver- individual sports such as basketball, soccer, swimming, and
bal persuasion, and physiological state. Therefore, to badminton. Examples of nontraditional physical activity
increase physical activity self-efficacy in Singaporean options include after-school walking programs, skateboard-
adolescents, intervention programs should: (1) provide ing, and exergames such as Dance Dance Revolution.
enjoyable, developmentally appropriate positive physical The present study found that parental support was a key
activity experiences (e.g., emphasize moderate to vigorous influence on physical activity behavior for both boys and
intensity activities such as brisk walking); (2) create girls. This finding is in accordance with results of previous
opportunities to observe significant others (e.g., parents, investigations [26]. The positive effects of parental support
peers, teachers) perform physical activity; (3) provide for physical activity suggest that health practitioners and
reinforcement to participate in physical activity (e.g., well educators should aim to increase parental supportive
done, keep it up); and (4) reduce any anxiety associated with behaviors when designing and implementing physical
Int.J. Behav. Med. (2010) 17:279286 285

activity intervention programs. This can be accomplished nally examined the correlates of physical activity over a 3-
by teaching parents to: (1) facilitate access to physical year period, access to exercise-related items measured in
activity opportunities by signing up their child for physical the fifth and sixth grades was not a significant predictor of
activity programs; (2) provide transportation to recreational physical activity behavior among girls in the eighth and
facilities (e.g., parks); (3) observe their child participate in ninth grades.
physical activity; (4) counsel their child that physical This study had a number of limitations that warrant
activity is good for health; and (5) provide appropriate consideration. First, the cross-sectional design of the present
levels of positive reinforcement for their childs mastery study precluded us from inferring a causal relationship
attempts in physical activity. between the hypothesized correlates and physical activity
In the present study, involvement in school sports was a behavior. Second, the use of self-report measure of physical
significant positive correlate of physical activity in boys and activity may be subject to recall bias and social desirability
girls. Our results are similar to that of previous studies, effects. Third, we were only able to explain a small
showing that participation in community sports and physical percentage of the variance in physical activity behavior (i.e.,
activity programs are significant predictors of moderate to 10% in boys and 8% in girls). This latter observation suggests
vigorous physical activity among school-aged children [27, that other variables not measured in this study could be salient
28]. This suggests that an effective way to increase physical influences on physical activity behavior in Singaporean
activity in adolescent boys and girls is to promote greater adolescents. It is likely that time spent outdoors, sedentary
access of physical activity programs in schools and opportunities, the built environment, and land use policies
communities. To achieve this, community programs should (e.g., activity friendly community design programs that
provide a range of developmentally appropriate physical promote physical activity) are important influences on
activities that cater to the needs of adolescents. To increase physical activity behavior among Singaporean adolescents.
awareness of community-based sports and physical activity Therefore, in addition to the influences examined in the
programs, local recreational community centers should present study, future investigations should evaluate the
actively collaborate with schools to educate parents and relative importance of environmental and policy influences
students of their physical activity programs. on activity levels among Singaporean youth. Notwithstanding
An interesting finding from the present study was that these limitations, we have identified a number of important
access to sports/fitness equipment at home was a significant correlates of physical activity that can be targeted by
positive correlate of physical activity among girls, but not intervention programs for Singaporean high school students.
boys. Previous investigations have reported similar results. In In summary, physical activity self-efficacy, enjoyment of
a 5-year longitudinal study of Canadian adolescent girls, physical activity, parental support, and participation in sports
Butcher [29] observed availability of sports equipment to be teams were key correlates of physical activity in Singaporean
a significant positive predictor of sustained involvement in adolescents. To further increase our understanding of
physical activity. In their examination of the correlates of physical activity behavior in Singaporean youth, future
physical activity in the fifth- and sixth-grade students, studies should examine the influence of policy and the built
Stucky-Ropp and DiLorenzo [24] observed the number of environment on physical activity behavior and, where
exercise-related items in the home to be positively associated possible, utilize objective measures of physical activity.
with physical activity in girls, but not boys. Similarly, Trost Additionally, future studies should examine the correlates of
and colleagues [30] reported access to sporting/fitness physical activity in other age groups of Singaporean youth
equipment to be positively associated with objectively such as preschoolers and elementary school children.
measured moderate physical activity in girls. No relationship
was observed for physical activity of any intensity in boys.
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