Epidemiology of exercise and physical activity

1. Epidemiology of exercise and physical activity MARY THOMAS M.B.& B.S., M.P.H.Communities Putting Prevention to WorkCity of San AntonioMetropolitan Health District

2. Relationship between physical activity and mental health among Texas adolescents – the role of physical education (PE) class attendance Alice Fang Yan MD PhD Mary Thomas, MPH (presenter) Katherine Velasquez, RN, PhD Gentry Kuehn, MS Sha Ge, MA, PhD

3. Presenter Disclosures The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: Mary Thomas “No relationships to disclose”

4. Youth Risk Behavior Survey TEXAS 2009 • Focus on behaviors among youth causing important health problems • Assess how risk behaviors change over time • Unintentional injuries and violence • Tobacco use • Alcohol and other drug use • Sexual behaviors • Unhealthy dietary behaviors • Inadequate physical activity • Provide comparable data

5. Learn how theory based analysis is applied Understand the complex relationship between physical activity and mental health Understand the positive contribution of attending PE classes on mental health of adolescents PRESENTATION LEARNING OBJECTIVES

6. Background: Physical Activity Improves Mental Health

7. Objective To assess association of physical activity (PA), particularly attending physical education (PE) classes, with four mental health outcomes : (1) feelings of sadness or hopeless, (2) considering suicide, (3) making suicide plan, and (4) attempting suicide) among Texas adolescents (9th – 12th graders).

8. Methods • A sample of 3,168 adolescents (grades 9 through 12) from the 2009 Texas Youth Risk Behavior Survey (YRBS) was examined. • Dependent variables: four mental health outcomes : (1) feelings of sadness or hopeless, (2) considering suicide, (3) making suicide plan, and (4) attempting suicide) • Independent variables of interests: (1) Active 60 min on 5+ past 7 days; (2) Attended PE class 1+ days average week; (3) Participated in 1+ sports team, and (4) Attended PE class daily • Covariates: grade, race, substance use/abuse, overweight or obese • Statistical analyses were conducted using SAS 9.2 (Cary, NC), which accounts for multistage sampling.

9. Methods: Analysis • Estimate the prevalence; Chi-square tests were used to examine the strength of association between each of the independent variables and the outcome variables. • Univariate logistic regression models (data not shown) • Multivariate logistic regression was used to identify the most significant variables in relation to the mental health outcome variables. The final model included all statistically significant independent variables (p<.05) from the univariate logistic regression models. Adjusted ORs and 95% CI were examined to assess the significance of their unique relationship to outcome variables.

10. Results: Prevalence of Mental Health Problems by Independent Variables (IV)

11. Results • Multivariate analysis revealed that self-reported NOT participating in physical activity for at least 60 minutes per day on five or more days of the past week was associated with increased risk of all four depression or suicidal behaviors.

12. Results • NOT attending PE classes daily was associated with increased risk in • Contemplating suicide (OR=1.791, 95% CI = 1.168 ~ 2.746) • Planning suicide (OR=2.295, 95% CI = 1.316 ~ 4.002) • Attempting suicide (OR=3.038, 95% CI = 1.749 ~ 5.276)

13. Results: Multivariate Logistic Regression

14. Results: Multivariate Logistic Regression

15. Conclusion

16. THANK YOU QUESTIONS ???