Physical activity and health-related quality of life among schoolchildren from disadvantaged neighbourhoods in Port Elizabeth, South Africa
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The relationship between health-related quality of life (HRQoL), physical activity (PA), and cardiorespiratory fitness (CRF) among disadvantaged communities in low- and middle-income countries is poorly understood. In South Africa, children from socioeconomically deprived households are at an elevated risk of sedentary lifestyles and poor HRQoL. We examined whether higher self-reported PA and higher CRF levels are associated with better HRQoL in South African schoolchildren from disadvantaged neighbourhoods.
Overall, 832 children aged 8–12 years participated in this cross-sectional study. HRQoL was assessed through five dimensions of the KIDSCREEN-27 tool. Self-reported PA was measured using a single item of the Health-Behaviour of School-Aged Children test, and CRF with the 20-m shuttle run test.
Higher self-reported PA was significantly and positively related to HRQoL. Significant, but small group differences existed across all dimensions of HRQoL between low and high self-reported PA. No significant associations were observed between CRF levels and HRQoL.
Schoolchildren reporting PA of at least 60 min on at least 6 days a week (the recommended minimum) report higher HRQoL than their peers with lower PA levels.
KeywordsHealth-related quality of life Physical activity Cardiorespiratory fitness Schoolchildren South Africa
We are grateful to Ms. Siphesihle Nqweniso, Ms. Larissa Adams, Ms. Danielle Smith, Ms. Dominique Bänninger, Mr. Thomas Hager, and Ms. Nandi Joubert for their contribution to data collection. We also thank Mr. Bruce Damons and Ms. Mariandah Gerwel for enabling contacts to schools and their contribution to data collection.
This study was financially supported by the Swiss-South African Joint Research Programme (SSAJRP), jointly funded by the Swiss National Science Foundation (SNSF; project no. IZLSZ3 149015) and the National Research Foundation (NRF) in South Africa (project no. 87397). The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Compliance with ethical standards
Conflict of interest
None of the authors have any conflict of interest.
The study was approved by the ethical review board of North-western and Central Switzerland (reference no. EKNZ 2014-179), the Nelson Mandela University Human Ethics Committee (reference no. H14-HEA-HMS-002), the Eastern Cape Department of Education, and the Eastern Cape Department of Health in Port Elizabeth, South Africa. All procedures performed in the study were in accordance with the ethical standards described in the institutional research committees and with the 1964 Helsinki declaration and its later amendments.
Each child provided oral assent and written informed consent was obtained from parents/guardians.
- 7.von Rueden, U., Gosch, A., Ramjl, L., Bisegger, C., Ravens-Sieberer, U., & the European Kidscreen Group (2006). Socioeconomic determinants of health related quality of life in childhood and adolescence: Results from a European study. Journal of Epidemiology and Community Health, 60, 130–135.CrossRefGoogle Scholar
- 11.Helseth, S., Haraldstad, K., & Christophersen, K. A. (2015). A cross-sectional study of health related quality of life and body mass index in a Norwegian school sample (8–18 years): A comparison of child and parent perspectives. Health and Quality of Life Outcomes, 13, 47. doi: 10.1186/s12955-12015-10239-z.Google Scholar
- 14.Kohl, H. W. R., & Murray, T. (2012). Foundations of physical activity and public health. Champaign: Human Kinetics.Google Scholar
- 16.Wafa, S., Rhahril, M., Ahmad, A., Zainuddin, L., Simail, K., Aung, M., et al. (2016). Association between physical activity and health-related quality of life in children: A cross-sectional study. Health and Quality of Life Outcomes, 14, 71. doi: 10.1186/s12955-12016-10474-y.PubMedPubMedCentralGoogle Scholar
- 23.Van Hout, R., Young, M., Bassett, S., & Hooft, T. (2013). Participation in sport and the perceptions of quality of life of high school learners in the Theewaterskloof Municipality, South Africa. African Journal for Physical Activity and Health Sciences, 19, 612–622.Google Scholar
- 24.Pühse, U., & Gerber, M. (2005). International comparison of physical education. Concepts, problems, prospects. Aachen: Meyer & Meyer.Google Scholar
- 26.Walter, C. M. (2011). In-school physical activity patterns of primary school learners from disadvantaged schools in South Africa. African Journal of Physical and Health Education, Recreation and Dance, 17, 780–789.Google Scholar
- 27.Hall, K., & Giese, S. (2009). Addressing quality through school fees and school funding. In S. Pendlebury, L. Lake, & C. Smith (Eds.), South African child gauge (pp. 35–40). Cape Town: Children’s Institute, University of Cape TownGoogle Scholar
- 29.Inchley, J., Currie, D., Young, T., Samdal, O., Torsheim, T., Auguston, L., et al. (2016). Growing up unequal: Gender and socioeconomic differences in young people’s health and well-being. Health Behaviour in School-aged Children (HBSC) study: International report from the 2013/2014 survey. Health Policy for Children and Adolescents, 7, 276–276.Google Scholar
- 30.United States Department of Health and Human Services. (2008). 2008 physical activity guidelines for Americans. Washington, DC: U.S. Government Printing Office.Google Scholar
- 31.Biddle, S. J., Cavill, N., & Sallis, J. F. (1998). Policy framework for young people and health-enhancing physical activity. In S. J. Biddle, J. F. Sallis & N. Cavill (Eds.), Young and active? Young people and health-enhancing physical activity – Evidence and implications (pp. 3–16). London: Health Education Authority.Google Scholar
- 33.The Kidscreen Group Europe (2006). The KIDSCREEN questionnaires: Quality of life questionnaires for children and adolescents. Lengerich: Pabst Science.Google Scholar
- 34.WHO. (2007). Growth reference 5–19 years. Geneva: World Health Organization.Google Scholar
- 35.Hair, J. F., Black, W. C., Babin, B. J., & Anderson, R. E. (2010). Multivariate data analysis. Upper Saddle River: Pearson Education.Google Scholar
- 36.Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Mahwah: Erlbaum.Google Scholar
- 37.Nunnally, J., & Bernstein, B. (1994). Psychometric theory. New York: McGraw-Hill.Google Scholar
- 39.WHO (2016). WHO fact sheet: Physical activity in adolescents (15 March 2016). Geneva: World Health Organization.Google Scholar
- 44.Brand, S., Kalak, N., Gerber, M., Clough, P. J., Lemola, S., Bahmani, S. D., et al (2017). During early to mid adolescence, moderate to vigorous physical activity is associated with restoring sleep, psychological functioning, mental toughness and male gender. Journal of Sport Sciences, 35, 426–434.CrossRefGoogle Scholar
- 45.Gerber, M., Endes, K., Brand, S., Herrmann, C., Colledge, F., Donath, L., et al. (2017). In 6- to 8-year-old children, cardiorespiratory fitness moderates the relationship between severity of life events and health-related quality of life. Quality of Life Research, 26, 695–706.CrossRefPubMedGoogle Scholar
- 47.Martikainen, S., Pesonen, A. K., Lahti, J., Heinonen, K., Feldt, K., Pyhälä, R., et al. (2013). Higher levels of physical activity are associated with lower hypothalamic-pituitary-adrenocortical axis reactivity to psychosocial stress. Journal of Clincal Endocrinology and Metabolism, 98, 619–627.CrossRefGoogle Scholar
- 48.Lang, C., Kalak, N., Brand, S., Holsboer-Trachsler, E., Pühse, U., & Gerber, M. (2016). The relationship between physical activity and sleep from mid adolescence to early adulthood. A systematic review of methodological approaches and meta-analysis. Sleep Medicine Reviews, 58, 32–45.CrossRefGoogle Scholar
- 49.Hatzinger, M., Brand, S., Perren, S., Stadelmann, S., von Wyl, A., von Klitzing, K., et al. (2010). Sleep actigraphy pattern and behavioral/emotional difficulties in kindergarten children: Association with hypothalamic-pituitary-adrenocortical (HPA) activity. Journal of Psychiatric Research, 44, 253–261.CrossRefPubMedGoogle Scholar
- 50.Korczak, D. J., Madigan, S., & Colasanto, M. (2017). Children’s physical activity and depression: A meta-analysis. Pediatrics, 139(4). doi: 10.1542/peds.2016-2266.
- 52.Zahl, T., Steinsbekk, S., & Wichstrøm, L. (2017). Physical activity, sedentary behavior, and symptoms of major depression in middle childhood. Pediatrics, 139(2). doi: 10.1542/peds.2016-1711.
- 53.Ekelund, U., Anderssen, S. A., Froberg, K., Sardinha, L. B., Andersen, L. B., Brage, S., et al. (2007). Independent associations of physical activity and cardiorespiratory fitness with metabolic risk factors in children: The European Youth Heart Study. Diabetologia, 50, 1832–1840.CrossRefPubMedGoogle Scholar
- 55.Bouchard, C., Malina, R. M., & Perusse, L. (1997). Genetics of fitness and physical activity (p. 408). Champaign: Human Kinetics.Google Scholar
- 56.Byrne, B. M. (2010). Structural equation modeling with AMOS. Basic concepts, applications, and programming. New York: Taylor & Francis.Google Scholar
- 59.Gall, S., Müller, I., Walter, C., Seelig, H., Steenkamp, L., Pühse, U., et al. (2017). Associations between selective attention and soil-transmitted helminth infections, socioeconomic status and physical fitness in disadvantaged children in Port Elizabeth, South Africa: An observational study. PLoS Neglected Tropical Diseases. doi: 10.1371/journal.pntd.0005573.PubMedPubMedCentralGoogle Scholar
- 62.Ravens-Sieberer, U., Auquier, P., Erhart, M., Gosch, A., Rajmil, L., Bruil, J., et al. (2007). The KIDSCREEN-27 quality of life measures for children and adolescents: Psychometric results from a cross-cultural survey in 13 European countries. Quality of Life Research, 16, 1347–1356.CrossRefPubMedGoogle Scholar
- 63.Hall, K., Sambu, W. L. B., Giese, S., Almeleh, C., & Rosa, S. (2016). South African early childhood review 2016. Cape Town: Children’s Institute, University of Cape Town and Ilifa Labantwana.Google Scholar
- 64.DoBE (2014). National School Nutrition Programme. Report 2013/2014. Pretoria: Department of Basic Education.Google Scholar