Psychosocial moderators of associations between life events and changes in physical activity after leaving high school
Introduction
Physical inactivity is the fourth leading risk factor for premature all-cause mortality, responsible for an estimated 3.2 million deaths globally (World Health Organization, 2013). In Australia, physical inactivity is associated with 10.1% of all-cause mortality (Lee et al., 2012). Physical activity (PA) levels begin to decline in adolescence and this continues into young adulthood (Dumith et al., 2011, Gordon-Larsen et al., 2004, Kimm et al., 2000, Poobalan et al., 2012). The period when young people leave high school is thought to have a powerful influence on health behaviours and subsequent weight gain (Crombie et al., 2009, Keating et al., 2005, Laska et al., 2009, Wengreen and Moncur, 2009). This transition, termed emerging adulthood, is a critical period of decision-making (Bell and Lee, 2005) where major life events such as changes in employment status, residence, physical status and relationships can affect PA participation (Allender et al., 2008). However, with the exception of beginning tertiary education, longitudinal studies examining participation in PA both before and after key life events are limited (Allender et al., 2008, Jose et al., 2011).
It is possible that associations between PA and life events following high school may be stronger in some groups than others. For example, in the first year after leaving high school, rural young people often relocate to seek further education or employment opportunities, and thus may be at particular risk of declines in PA. PA participation is lower among rural adolescents than their metropolitan counterparts (Martin et al., 2005). Consistent with Social Cognitive Theory (Bandura, 1986), psychological factors (such as self-efficacy, enjoyment and outcome expectations) and the social environment (family and friend support and club membership) may be important effect modifiers that protect against declines in PA associated with particular life events. For example, potential negative associations between starting full-time employment and PA may be more pronounced among those who had lower levels of family or friend support in high school. While these constructs are important correlates of PA among adolescents (Davison and Lawson, 2006, Van der Horst et al., 2007) or determinants of longitudinal changes in PA between adolescence and adulthood (Craggs et al., 2011), their potential role in moderating associations between life events and changes in PA has not been examined.
This study aimed to examine: 1) associations between life events and changes in leisure-time physical activity (LTPA) after leaving high school in young people from rural areas of Western Australia; and 2) whether these associations are moderated by psychosocial factors.
Section snippets
Study design and participants
Prospective data from the Rural Activity Project (RAP) were used. Senior, district and remote high schools in rural Western Australia were stratified by student population size: 50–100 students; > 100 students. Eighty-one randomly selected high schools were approached, of which 50 (61%) agreed to participate by distributing screening surveys to students in their final year of high school (Year 12). These were returned by 43 (84%) schools. Passive parental consent was sought prior to data
Results
In total, 440 young people (50.9% male) completed baseline (T1) and the first follow-up survey 12 months later (T2) and 374 of these participants (50.5% male) also completed the second survey a further 12 months later (T3). Repeated measures showed a significant decline in LTPA between all three time points (p < 0.001). Table 1 shows that at baseline, young people spent approximately 5.5 h/week doing LTPA. After 12 months, they did 4.6 h and after 24 months, the amount of LTPA declined to 4.3 h/week. At
Discussion
This study showed a decline in LTPA of more than 1 h/week two years after leaving high school, which is consistent with previous studies examining PA during the transition from adolescence to adulthood (Gordon-Larsen et al., 2004, Poobalan et al., 2012). However, moving out of home was not associated with the decline in LTPA 12 months or 24 months after leaving school. Moreover, there were no interactions between potential psychosocial moderators and moving out of home after one year or two years
Conclusion
This study found evidence of substantial declines in PA among rural school leavers. With the exception of entering further education, few of the life events examined were associated with these declines. The results suggest that it may be important to intervene before students leave school to prepare them for a range of circumstances and demands they are likely to encounter after leaving school and equip them with strategies to maintain healthy lifestyle behaviours in the face of these changes.
Conflict of interest statement
The authors declare there is no conflict of interest.
Acknowledgments
This study was funded by a grant from the Western Australian Health Promotion Foundation (Healthway) (11854). Anna Timperio is supported by a National Heart Foundation of Australia Future Leader Fellowship (Award ID: 100046). Dorien Simons is supported by a FWO fellowship (Fund for Scientific Research Flanders) (11U8114N). Jo Salmon is supported by a National Health and Medical Research Council Principal Research Fellowship (APP1026216). Analyses for the current paper were part of the MeMo
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