Skip to main content


Log in

Screen time and physical activity behaviours are associated with health-related quality of life in Australian adolescents

  • Published:
Quality of Life Research Aims and scope Submit manuscript



To explore the cross-sectional relationships between health-related quality of life (HRQoL) and physical activity (PA) behaviours and screen-based media (SBM) use among a sample of Australian adolescents.


Data came from baseline measures collected for the It’s Your Move! community-based obesity prevention intervention. Questionnaire data on sociodemographics, PA, SBM and HRQoL were collected from 3,040 students (56% boys) aged 11–18 years in grade levels 7–11 in 12 secondary schools. Anthropometric data were measured.


The highest level of PA at recess, lunchtime and after school was associated with higher HRQoL scores (boys, by 5.3, 8.1, 6.3 points; girls, by 4.2, 6.1, 8.2 points) compared with not being active during these periods. Exceeding 2 h of SBM use each day was associated with significantly lower HRQoL scores (boys, by 3.2 points; girls, by 4.0 points). Adolescents who were physically active and low SBM users on school days had higher HRQoL scores (boys, by 6.6 points; girls, by 7.8 points) compared with those who were not physically active every school day and high SBM users on school days.


Several of the relationships between low PA and high SBM use and HRQoL were comparable to those previously observed between chronic disease conditions and HRQoL, indicating that these behaviours deserve substantial attention.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others


  1. McHorney, C. A. (1999). Health status assessment methods for adults: Past accomplishments and future challenges. Annual Review of Public Health, 20, 309–335.

    Article  PubMed  CAS  Google Scholar 

  2. Varni, J. W., Seid, M., Knight, T. S., Uzark, K., & Szer, I. S. (2002). The PedsQL 4.0 generic core scales: Sensitivity, responsiveness, and impact on clinical decision-making. Journal of Behavioral Medicine, 25(2), 175–193.

    Article  PubMed  Google Scholar 

  3. Centers for Disease Control and Prevention. (2000). Measuring healthy days: Population assessment of helath-related qulaity of life. Atlanta, Georgia: CDC. Available from:

  4. Salo, P. K., Hakkinen, A. H., Kautiainen, H., & Ylinen, J. J. (2010). Effect of neck strength training on health-related quality of life in females with chronic neck pain: A randomized controlled 1-year follow-up study. Health Quality and Life Outcomes, 8, 48.

    Article  Google Scholar 

  5. Schwimmer, J. B., Burwinkle, T. M., & Varni, J. W. (2003). Health-related quality of life of severely obese children and adolescents. JAMA, 289(14), 1813–1819.

    Article  PubMed  Google Scholar 

  6. Soni, R. K., Porter, A. C., Lash, J. P., & Unruh, M. L. (2010). Health-related quality of life in hypertension, chronic kidney disease, and coexistent chronic health conditions. Advances in Chronic Kidney Disease, 17(4), e17–e26.

    Article  PubMed  Google Scholar 

  7. Sikdar, K. C., Wang, P. P., MacDonald, D., & Gadag, V. G. (2010). Diabetes and its impact on health-related quality of life: A life table analysis. Quality of Life Research, 19(6), 781–787.

    Article  PubMed  Google Scholar 

  8. Speyer, E., Herbinet, A., Vuillemin, A., Briançon, S., & Chastagner, P. (2010). Effect of adapted physical activity sessions in the hospital on health-related quality of life for children with cancer: A cross-over randomized trial. Pediatric Blood & Cancer, 55(6), 1160–1166.

    Article  Google Scholar 

  9. Rejeski, W. J., Brawley, L. R., & Shumaker, S. A. (1996). Physical activity and health-related quality of life. Exercise and Sport Sciences Reviews, 24, 71–108.

    Article  PubMed  CAS  Google Scholar 

  10. Frisen, A. (2007). Measuring health-related quality of life in adolescence. Acta Paediatrica, 96(7), 963–968.

    Article  PubMed  Google Scholar 

  11. Bize, R., Johnson, J. A., & Plotnikoff, R. C. (2007). Physical activity level and health-related quality of life in the general adult population: A systematic review. Preventive Medicine, 45(6), 401–415.

    Article  PubMed  Google Scholar 

  12. Kruger, J., Bowles, H. R., Jones, D. A., Ainsworth, B. E., & Kohl, H. W., I. I. I. (2007). Health-related quality of life, BMI and physical activity among US adults (>/=18 years): National physical activity and weight loss survey, 2002. International Journal of Obesity (London), 31(2), 321–327.

    Article  CAS  Google Scholar 

  13. Brown, D. W., Brown, D. R., Heath, G. W., Balluz, L., Giles, W. H., Ford, E. S., et al. (2004). Associations between physical activity dose and health-related quality of life. Medicine and Science in Sports and Exercise, 36(5), 890–896.

    PubMed  Google Scholar 

  14. Shoup, J. A., Gattshall, M., Dandamudi, P., & Estabrooks, P. (2008). Physical activity, quality of life, and weight status in overweight children. Quality of Life Research, 17(3), 407–412.

    Article  PubMed  Google Scholar 

  15. Iannotti, R. J., Kogan, M. D., Janssen, I., & Boyce, W. F. (2009). Patterns of adolescent physical activity, screen-based media use, and positive and negative health indicators in the U.S. and Canada. Journal of Adolescent Health, 44(5), 493–499.

    Article  PubMed  Google Scholar 

  16. Iannotti, R. J., Janssen, I., Haug, E., Kololo, H., Annaheim, B., & Borraccino, A. (2009). Interrelationships of adolescent physical activity, screen-based sedentary behaviour, and social and psychological health. International Journal of Public Health, 54(Suppl 2), 191–198.

    Article  PubMed  Google Scholar 

  17. Aarnio, M., Winter, T., Kujala, U., & Kaprio, J. (2002). Associations of health related behaviour, social relationships, and health status with persistent physical activity and inactivity: A study of Finnish adolescent twins. British Journal of Sports Medicine, 36(5), 360–364.

    Article  PubMed  CAS  Google Scholar 

  18. Kantomaa, M. T., Tammelin, T. H., Demakakos, P., Ebeling, H. E., & Taanila, A. M. (2010). Physical activity, emotional and behavioural problems, maternal education and self-reported educational performance of adolescents. Health Education Research, 25(2), 368–379.

    Article  PubMed  CAS  Google Scholar 

  19. Ussher, M. H., Owen, C. G., Cook, D. G., & Whincup, P. H. (2007). The relationship between physical activity, sedentary behaviour and psychological wellbeing among adolescents. Social Psychiatry and Psychiatric Epidemiology, 42(10), 851–856.

    Article  PubMed  Google Scholar 

  20. Steptoe, A., & Butler, N. (1996). Sports participation and emotional wellbeing in adolescents. Lancet, 347(9018), 1789–1792.

    Article  PubMed  CAS  Google Scholar 

  21. Fulton, J. E., Wang, X., Yore, M. M., Carlson, S. A., Galuska, D. A., & Caspersen, C. J. (2009). Television viewing, computer use, and BMI among U.S. children and adolescents. Journal of Physical Activity and Health, 6(Suppl 1), S28–S35.

    PubMed  Google Scholar 

  22. Eisenmann, J. C., Bartee, R. T., & Wang, M. Q. (2002). Physical activity, TV viewing, and weight in U.S. youth: 1999 Youth Risk Behavior Survey. Obesity Research, 10(5), 379–385.

    Article  PubMed  Google Scholar 

  23. Hardy, L. L., Dobbins, T., Booth, M. L., Denney-Wilson, E., & Okely, A. D. (2006). Sedentary behaviours among Australian adolescents. Australian and New Zealand Journal of Public Health, 30(6), 534–540.

    Article  PubMed  Google Scholar 

  24. Burke, V., Beilin, L. J., Durkin, K., Stritzke, W. G., Houghton, S., & Cameron, C. A. (2006). Television, computer use, physical activity, diet and fatness in Australian adolescents. International Journal of Pediatric Obesity, 1(4), 248–255.

    Article  PubMed  Google Scholar 

  25. Department of Health and Ageing. (2004). Australia’s physical activity recommendations for 1218 year olds. Canberra, ACT: Department of Health and Ageing. Available from:

  26. Schultz, J., Utter, J., Mathews, L., Cama, T., Mavoa, H., & Swinburn, B. (2007). The Pacific OPIC Project (Obesity Prevention in Communities): Action plans and interventions. Pacific Health Dialog, 14(2), 147–153.

    PubMed  Google Scholar 

  27. Swinburn, B., Pryor, J., McCabe, M., Carter, R., de Courten, M., Schaaf, D., et al. (2007). The Pacific OPIC Project (Obesity Prevention in Communities)—Objectives and designs. Pacific Health Dialog, 14(2), 139–146.

    PubMed  Google Scholar 

  28. Utter, J., Scragg, R., Schaaf, D., & Mhurchu, C. N. (2008). Relationships between frequency of family meals, BMI and nutritional aspects of the home food environment among New Zealand adolescents. International Journal of Behavioral Nutrition and Physical Activity, 5, 50.

    Article  PubMed  Google Scholar 

  29. Mathews, L., Kremer, P., Sanigorski, A., Simmons, A., Nichols, M., Moodie, M., et al. (2009). Nutrition and physical activity in children and adolescents: Report 1: Methods and tools. Melbourne: Department of Human Services (Victoria). Available from:

  30. Australian Bureau of Statistics. (2010). Information paper: An introduction to socio-economic indexes for areas (SEIFA), 2006. ABS Catalogue No. 2039.0. Canberra, ACT: Australian Bureau of Statistics. Available from:

  31. Ministry of Health. (2003). NZ food NZ children: Key results of the 2002 national children’s nutrition survey. Wellington: Ministry of Health. Available from:

  32. Varni, J. W., Seid, M., & Rode, C. A. (1999). The PedsQL: Measurement model for the pediatric quality of life inventory. Medical Care, 37(2), 126–139.

    Article  PubMed  CAS  Google Scholar 

  33. Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQL 4.0: Reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Medical Care, 39(8), 800–812.

    Article  PubMed  CAS  Google Scholar 

  34. Varni, J. W., Burwinkle, T. M., Seid, M., & Skarr, D. (2003). The PedsQL 4.0 as a pediatric population health measure: Feasibility, reliability, and validity. Ambulatory Pediatrics, 3(6), 329–341.

    Article  PubMed  Google Scholar 

  35. Davies, P., Roodvelt, R., & Marks, G. (2001). Standard methods for the collection and collation of anthropometric data in children. Canberra, ACT: National Food and Nutrition Moniotirng and Surveillance Project. Available from:$File/anthropometric.pdf.

  36. de Onis, M., Onyango, A. W., Borghi, E., Siyam, A., Nishida, C., & Siekmann, J. (2007). Development of a WHO growth reference for school-aged children and adolescents. Bulletin of the World Health Organization, 85(9), 660–667.

    Article  PubMed  Google Scholar 

  37. Pate, R. R., Davis, M. G., Robinson, T. N., Stone, E. J., McKenzie, T. L., & Young, J. C. (2006). Promoting physical activity in children and youth: A leadership role for schools: A scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism (Physical Activity Committee) in collaboration with the Councils on Cardiovascular Disease in the Young and Cardiovascular Nursing. Circulation, 114(11), 1214–1224.

    Article  PubMed  Google Scholar 

  38. Boyle, S. E., Jones, G. L., & Walters, S. J. (2010). Physical activity, quality of life, weight status and diet in adolescents. Quality of Life Research, 19(7), 943–954.

    Article  PubMed  Google Scholar 

  39. Sallis, J. F., Prochaska, J. J., & Taylor, W. C. (2000). A review of correlates of physical activity of children and adolescents. Medicine and Science in Sports and Exercise, 32(5), 963–975.

    PubMed  CAS  Google Scholar 

  40. Vogt Yuan, A. S. (2010). Body perceptions, weight control behavior, and changes in adolescents’ psychological well-being over time: A longitudinal examination of gender. Journal of Youth and Adolescence, 39(8), 927–939.

    Article  PubMed  Google Scholar 

  41. Hallal, P. C., Victora, C. G., Azevedo, M. R., & Wells, J. C. (2006). Adolescent physical activity and health: A systematic review. Sports Medicine, 36(12), 1019–1030.

    Article  PubMed  Google Scholar 

  42. Page, A. S., Cooper, A. R., Griew, P., & Jago, R. (2010). Children’s screen viewing is related to psychological difficulties irrespective of physical activity. Pediatrics, 126(5), e1011–e1017.

    Article  PubMed  Google Scholar 

  43. Brown, J. D., & Witherspoon, E. M. (2002). The mass media and American adolescents’ health. Journal of Adolescent Health, 31(6 Suppl), 153–170.

    Article  PubMed  Google Scholar 

  44. Allender, S., Kremer, P., de Silva-Sanigorski, A., Lacy, K., Millar, L., Mathews, L., et al. (in press). Associations between activity-related behaviours and standardized BMI among Australian adolescents. Journal of Science and Medicine in Sport (corrected proof).

  45. Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). Impaired health-related quality of life in children and adolescents with chronic conditions: A comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the PedsQL (TM) 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5(43).

  46. Carlson, S. A., Fulton, J. E., Lee, S. M., Foley, J. T., Heitzler, C., & Huhman, M. (2010). Influence of limit-setting and participation in physical activity on youth screen time. Pediatrics, 126(1), e89–e96.

    Article  PubMed  Google Scholar 

Download references


This project was funded by the Victorian Department of Human Services as part of the Victorian ‘Go for your life’ Healthy Eating and Physical Activity initiative, in conjunction with VicHealth and the National Health and Medical Research Council. We acknowledge the principals, teachers, students and School Project Officers (Sue Blackett, Lee Denny, Kerryn Fearnsides, Chris Green, Sonia Kinsey, Kirsty Licheni, Kate Meadows, Lauren Reading and Lyndal Taylor) from the 12 schools involved in the project. Acknowledged also are Colin Bell and others from the ‘Support and Evaluation Team’, Anthony Bernardi, Phil Day, Lawrence Meade, Lily Meloni and Narelle Robertson from the WHO Collaborating Centre for Obesity Prevention, Deakin University.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Kathleen E. Lacy.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lacy, K.E., Allender, S.E., Kremer, P.J. et al. Screen time and physical activity behaviours are associated with health-related quality of life in Australian adolescents. Qual Life Res 21, 1085–1099 (2012).

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: