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Screen-Based Behaviors of Adolescents in Bangladesh

Asaduzzaman Khan and Nicola W. Burton

Background:

The time spent by adolescents in electronic screen-based activities has been associated with obesity and other adverse health outcomes; however, little is known about screen-based behaviors in Asian adolescents. The purpose of this study was to describe the prevalence, patterns, and correlates of recreational screen-based behaviors among adolescents in Bangladesh.

Methods:

A total of 758 students (52% girls), aged 13 to 16 years, from 8 secondary schools of Dhaka city, Bangladesh, completed a survey in which the Adolescent Sedentary Activity Questionnaire was used to collect information on screen time. Total screen time was categorized as ≤2 h/day (low) or >2 h/day (high).

Results:

Approximately 79% of the adolescents had high recreational screen time, with similar values for boys (78%) and girls (80%). Median reported recreational screen time was 4.0 h/day; boys had longer times (4.3 h/day) than girls (3.6 h/day). Multivariable analyses showed that high screen time was more common among boys than girls and was positively associated with commuting to school by car, consumption of fast food ≥3 times/week, having sleep disturbance, and high family income.

Conclusions:

This study identified high rates of recreational screen time among urban adolescents in Bangladesh and specific correlates of prolonged screen time; the results underscore the need to develop pragmatic strategies to reduce sedentariness among adolescents in Bangladesh.

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Effects of a School-Based Physical Activity Intervention on Adolescents’ Mental Health: A Cluster Randomized Controlled Trial

Kazi Rumana Ahmed, Sharon Horwood, and Asaduzzaman Khan

Background: The aim of this study was to evaluate the effectiveness of a school-based multicomponent physical activity intervention on mental health of adolescents. Methods: A clustered, randomized, controlled trial was employed in 8 high schools in Dhaka, Bangladesh, which were randomly assigned to either an intervention or control group; 40 students in grades 8 and 9 from each school took part in the trial (n = 160/group). Students in the intervention schools participated in a 12-week physical activity intervention with multiple components (eg, supervised circuits, lunchtime sports, health education, infographics), while control schools received no intervention. Participants completed baseline and postintervention surveys measuring depressive symptoms (Center for Epidemiologic Studies Depression Scale) and life satisfaction (Cantril Ladder), along with other sociodemographic and behavioral characteristics. Linear mixed-effects modeling was used to evaluate the intervention effects. Results: Depressive symptoms in the intervention group decreased at postintervention, but remained stable in the control group. There was an increase in life satisfaction in the intervention group and a decrease in the control group. Multivariable modeling showed that students in the intervention group had a significantly lower level of depressive symptoms (β = −4.60; 95% confidence interval, −5.76 to −3.46) and higher level of life satisfaction (β = 1.43; 95% confidence interval, 0.77 to 2.10) compared with their counterparts in the control group. Sensitivity analyses supported the positive effects of the intervention. Conclusions: Our school-based, multicomponent physical activity intervention is effective in improving mental health indicators in adolescents. Future trials should be ramped up to include schools in rural and regional settings, using robust measures  of mental well-being.

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Economic Freedom, Climate Culpability, and Physical Activity Indicators Among Children and Adolescents: Report Card Grades From the Global Matrix 4.0

Eun-Young Lee, Patrick Abi Nader, Salomé Aubert, Silvia A. González, Peter T. Katzmarzyk, Asaduzzaman Khan, Wendy Y. Huang, Taru Manyanga, Shawnda Morrison, Diego Augusto Santos Silva, and Mark S. Tremblay

Background: Macrolevel factors such as economic and climate factors can be associated with physical activity indicators. This study explored patterns and relationships between economic freedom, climate culpability, and Report Card grades on physical activity-related indicators among 57 countries/jurisdictions participating in the Global Matrix 4.0. Methods: Participating countries/jurisdictions provided Report Card grades on 10 common indicators. Information on economic freedom and climatic factors were gathered from public data sources. Correlations between the key variables were provided by income groups (ie, low- and middle-income countries/jurisdictions and high-income countries/jurisdictions [HIC]). Results: HIC were more economically neoliberal and more responsible for climate change than low- and middle-income countries. Annual temperature and precipitation were negatively correlated with behavioral/individual indicators in low- and middle-income countries but not in HIC. In HIC, correlations between climate culpability and behavioral/individual and economic indicators were more apparent. Overall, poorer grades were observed in highly culpable countries/jurisdictions in the highly free group, while in less/moderately free groups, less culpable countries/jurisdictions showed poorer grades than their counterparts in their respective group by economic freedom. Conclusions: Global-level physical activity promotion strategies should closely evaluate different areas that need interventions tailored by income groups, with careful considerations for inequities in the global political economy and climate change.