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Factors of physical activity among Chinese children and adolescents: a systematic review
Open accessAbstract
BACKGROUND: Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development. METHODS: , 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method. RESULTS: Forty two papers (published 2002-2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents' physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents. CONCLUSIONS: The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood.
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![Fig. 2 Prevalence (%) of compliance with recommendations of physical activity in 15 studies is highly variable. a Recommendation to participate in physical activity for at least 60 min of MVPA per day; b Recommendation of three or more sessions per week of activities that last 20 min. or more, and that require moderate to vigorous levels of exertion (Sallis [92]); c Recommendation to participate in physical activity 3 or more times a week for at least 30 min, which entails deep breathing and increased heartbeat (Taiwanese recommendations for physical activity). d Chinese-specific cut-off points for accelerometry used in study (Wang et al., [48]). e Freedson’s cut-off points for accelerometry used in study (Wang et al., [48])](/paper-figures/2fe3319fb6f045aa909be73199732d06/factors-of-physical-activity-among-chinese-children-and-adolescents-a-systematic-figure-2.jpg)
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“Evidence from China indicates that there is a positive association between various forms of parental support, including parental encouragement, accompaniment, financial support, involvement, and role modelling, and high levels of physical activity participation among children and adolescents.106–108”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [106]
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“There is no clear evidence from China to suggest that socioeconomic status (eg, family socioeconomic status, parental education) is associated with levels of physical activity among Chinese children and adolescents.106”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [106]
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Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
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Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2010) · International Journal of Surgery · doi:10.1016/j.ijsu.2010.02.007 · Cited by 12,156
‘Small Changes' to Diet and Physical Activity Behaviors for Weight Management
Hills, A. P., Byrne, N. M., Lindstrom, R. C., & Hill, J. O. (2013) · Obesity Facts · doi:10.1159/000345030 · Cited by 9,526
Vandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., Egger, M., & Initiative, F. T. S. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040297 · Cited by 8,613
Global physical activity levels: surveillance progress, pitfalls, and prospects
Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., & Ekelund, U. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60646-1 · Cited by 5,711
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A review of correlates of physical activity of children and adolescents
SALLIS, J. F., PROCHASKA, J. J., & TAYLOR, W. C. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200005000-00014 · Cited by 4,421
Correlates of physical activity: why are some people physically active and others not?
Bauman, A. E., Reis, R. S., Sallis, J. F., Wells, J. C., Loos, R. J., & Martin, B. W. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60735-1 · Cited by 4,151
Vandenbroucke, J. P., von Elm, E., Altman, D. G., Gøtzsche, P. C., Mulrow, C. D., Pocock, S. J., Poole, C., Schlesselman, J. J., & Egger, M. (2007) · Epidemiology · doi:10.1097/ede.0b013e3181577511 · Cited by 2,779
Evaluation of the Quality of Prognosis Studies in Systematic Reviews
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Research works printed but not linked: 1
- World Health Organization. Global recommendations on physical activity for health. Geneva: World Health Organization; 2010.
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O’Donoghue, G., Kennedy, A., Puggina, A., Aleksovska, K., Buck, C., Burns, C., Cardon, G., Carlin, A., Ciarapica, D., Colotto, M., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0190737 · Cited by 347
Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)
Chen, P., Wang, D., Shen, H., Yu, L., Gao, Q., Mao, L., Jiang, F., Luo, Y., Xie, M., Zhang, Y., et al. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-102261 · Cited by 225
“106”
Barriers to high school and university students’ physical activity: A systematic review
Silva, R. M. F., Mendonça, C. R., Azevedo, V. D., Memon, A. R., Noll, P. R. E. S., & Noll, M. A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0265913 · Cited by 311
An, R., Shen, J., Yang, Q., & Yang, Y. (2019) · Journal of Sport and Health Science · doi:10.1016/j.jshs.2018.11.003 · Cited by 172
“A majority of children and adolescents in China fail to meet the recommended guidelines for PA levels.(55) 57 Although the traditional perspective mainly blamed individuals themselves for their sedentary lifestyles, increasing attention has now shifted to the environmental determinants of health behavior, in particula…”
BackgroundXiang, F., & Cao, Z. (2017) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2017.09.006 · Cited by 167
Metadata
- Authors
- Lu, C., Stolk, R. P., Sauer, P. J. J., Sijtsma, A., Wiersma, R., Huang, G., & Corpeleijn, E.
- Affiliations
- University Medical Center Groningen (NL)
- Tianjin Medical University (CN)
- Corresponding author
- Lu, Congchao
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2017-03-21
- Volume
- 14
- Issue
- 1
- Pages
- 36-36
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC5360041
- OpenAlex
- W2599960949
- Cited by
- 155
- References
- 96
- Citations by year
- 2026: 8 · 2025: 18 · 2024: 18 · 2023: 22 · 2022: 18 · 2021: 21 · 2020: 23 · 2019: 9 · 2018: 15 · 2017: 3
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- Universitair Medisch Centrum Groningen
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Social Sciences › Life-span and Life-course Studies › Recreational Sport and Physical Activity
- Keywords
- physical activity, children, adolescents, Chinese children, parental physical activity, self-efficacy, sex differences, urban-rural differences, socioeconomic status, physical activity promotion, physical environment
- MeSH terms
- Adolescent, Adolescent Behavior, Child, Child Behavior, China, Cross-Sectional Studies, Female, Humans, Male, Parents, Surveys and Questionnaires, Exercise, Self Efficacy, Observational Studies as Topic
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