BACKGROUND Despite global concerns regarding physical inactivity, limited cross-national evidence exists to compare adolescents' physical activity participation. We analysed data from 52 high- and low-middle income countries, with activity undertaken inside and outside of school in 2015. We investigated gender and socioeconomic disparities, and additionally examined correlations with country-level indices of physical education (PE) curriculum time allocation, wealth, and income inequality. METHODS We compared adolescents' reported activity levels inside and outside of school using nationally representative cross-sectional data from 52 high- and low-middle income countries (N = 347,935)-the Programme for International Student Assessment (PISA) in 2015. Students reported average attendance (days/week) in PE classes, and the days/week engaged in moderate activity (MPA) and vigorous activity (VPA) outside of school. We also compared gender and socioeconomic disparities, and additionally examined correlations with purported determinants-country-level estimates of PE curriculum time allocation, wealth, and income inequality. RESULTS Average activity levels differed substantially both between and within regions, with potentially important differences in distributions identified-such as a bimodal distribution in the U.S. and Canada in PE. Males were more active than females, as were those from households with higher rather than lower household wealth; these disparities were modest for PE, but higher for moderate and vigorous activity outside school-there was strong evidence for heterogeneity in the magnitude of these disparities (e.g., I2 > 95% for gender differences across all countries). PE class attendance was positively correlated with PE curriculum time allocation (rho = 0.36); activity outcomes were inconsistently associated with country-level wealth and income inequality. CONCLUSIONS Our findings reveal extensive cross-country differences in adolescents' physical activity; in turn, these highlight policy areas that could ultimately improve global adolescent health, such as the incorporation of minimum country-level PE classes, and the targeting of gender and socioeconomic disparities in activity conducted outside of school. Our findings also highlight the utility of educational databases such as PISA for use in global population health research.

中文翻译：

---

青少年的身体活动：52 个国家的水平、分布和差异的跨国比较。


背景尽管全球对缺乏身体活动感到担忧，但比较青少年身体活动参与情况的跨国证据有限。我们分析了 52 个高收入和中低收入国家 2015 年在校内外开展的活动的数据。我们调查了性别和社会经济差异，并另外研究了与国家级体育 (PE) 课程时间分配指数的相关性、财富和收入不平等。方法 我们使用国际学生评估计划 (PISA) 2015 年来自 52 个高收入和中低收入国家 (N = 347,935) 的全国代表性横截面数据，比较了青少年报告的校内和校外活动水平。学生报告体育课的平均出勤率（天/周），以及校外参加中等活动 (MPA) 和剧烈活动 (VPA) 的天数/周。我们还比较了性别和社会经济差异，并另外研究了与所谓的决定因素（国家层面对体育课程时间分配、财富和收入不平等的估计）的相关性。结果 地区之间和地区内部的平均活动水平差异很大，在分布上存在潜在的重要差异，例如美国和加拿大的 PE 呈双峰分布。男性比女性更活跃，家庭财富较高而非家庭财富较低的家庭的男性也比女性更活跃；对于体育运动来说，这些差异不大，但对于校外适度和剧烈的活动来说，这些差异更大——有强有力的证据表明这些差异的程度存在异质性（例如，所有国家的性别差异为 I2 > 95%）。 体育课出勤率与体育课程时间分配呈正相关（rho = 0.36）；活动成果与国家层面的财富和收入不平等并不一致。结论 我们的研究结果揭示了青少年身体活动方面存在广泛的跨国差异。反过来，这些政策重点突出了最终可以改善全球青少年健康的政策领域，例如纳入最低限度的国家级体育课程，以及在校外活动中针对性别和社会经济差异。我们的研究结果还强调了 PISA 等教育数据库在全球人口健康研究中的实用性。