Correlates of physical activity in First Nations youth residing in First Nations and northern communities in Canada.
Levesque, Lucie ; Janssen, Ian ; Xu, Fei 等
The Maskwachees Declaration acknowledges the importance of physical
activity (PA) for the promotion of holistic health among Aboriginal
Peoples. (1-3) For First Nations (FN) youth, PA plays an important role
in achieving balance among physical, mental, emotional and spiritual
elements of health. (4,5)
While little is known about the PA levels of FN youth, available
data suggest that inactivity is prevalent. For instance, a recent study
of self-reported moderate-to-vigorous physical activity (MVPA) from 204
on-reserve 10-16 year olds found that only 14% of boys and 4% of girls
met public health guidelines of at least 60 accumulated minutes of daily
MVPA. (6)
Understanding the factors that influence the PA behaviour of FN
youth represents a first step to fostering their positive PA habits. (7)
In the mainstream literature, behaviour theories and models provide a
systematic framework for examining the factors that influence PA. (8)
Ecological models, commonly used in the PA literature, (8,9) and which
are consistent with an Indigenous view of health and wellness, emphasize
the relatedness of the self with the external world and the
interconnectedness of humans to their physical, social and spiritual
surroundings. (10,11) It is thus relevant to consider influences upon PA
as occurring at multiple levels of human ecology, including individual
(e.g., age, gender, cultural beliefs), interpersonal (e.g.,
relationships and characteristics of family) and community levels (e.g.,
social and economic conditions, facilities, and programs) to better
inform the development of interventions to enhance PA in FN youth. (12)
Gender, age, socio-economic status (SES), parent and environmental
influences are among the most researched and consistent correlates of PA
in youth. (13,14) Relatively little information is available about the
ecological factors that influence PA among FN youth. (15)
The purpose of this study was to identify individual, family and
community factors independently associated with PA among FN youth aged
12-17 years. We assessed these associations in the 2008/10 Regional
Health Survey (RHS), which is a large and representative sample of FN
persons who reside in FN on-reserve and northern communities across
Canada.
METHODS
The RHS is a nationwide survey that addresses a holistic range of
priority health issues for FN, including PA. Development of the
questions was informed by FN experts from the First Nations Information
Governance Centre (FNIGC) to be meaningful to FN youth. Questions were
answered by youth during in-person interviews wherein local field
workers, overseen by FNIGC staff, used a Computer Assisted Personal
Interview (CAPI) system to record youth responses.
Participants
The RHS was designed to represent the FN population living in FN
communities (e.g., on-reserve and in northern Canada above the 60th
parallel) in all provinces and territories, except Nunavut. Indian and
Northern Affairs Canada (INAC) registry counts were used to derive
sample allocations, thereby ensuring adequate representation of the
population. Within the FN communities, band membership lists were used
to randomly select individuals. Overall, 216 communities were included
in the RHS and 5.3% of the FN population living in FN communities was
surveyed. The overall response rate among children, youth and adults was
72.5%. A total of 4,837 youth aged 12-17 years completed the RHS,
representing approximately 54,000 FN youth. Data were weighted using
INAC population counts, taking into account inclusion probabilities and
non-response rates. Youth who answered 'do not know' or
'refused' were excluded from the study. The total weighted
population represented in the final MVPA analysis was 41,664 persons
(i.e., 77% of represented 12-17 year old FN youth living on-reserve and
in northern FN communities). The corresponding numbers for the
traditional activities analysis were 48,558 and 90% respectively.
The RHS sample design incorporated a two-stage sampling strategy.
The first stage involved the selection of communities to participate in
the survey. Initially, all FN communities in Canada were stratified by
region, subregion, and community size [large (1,500+ people), medium
(300-1,499 people), and small (<300 people)]. Large communities were
automatically included, while medium and small communities were randomly
selected with equal probability within their respective strata. When a
randomly selected community chose not to participate, it was replaced
randomly with another community in the same subregion and size grouping.
The second stage of sampling pertained to the selection of
individuals within participating communities. All community members were
identified using band membership lists. Community members were randomly
selected within age/ gender groups from these lists. When a selected
community member chose not to participate, they were substituted from
the ordered randomly generated list. The sampling rate within each
community was determined as a function of the overall subregion
probability (within regions) and the probability of selection of the
community (within subregion) as per INAC registry counts.
Individual factors
Demographics. We considered age (12-14 years, 15-17 years) and
gender categories.
First Nations language. Use of FN language was grouped as follows:
'does not understand/speak a FN language',
'understands/speaks a FN language, but does not use most often in
daily life', and 'use of a FN language most often in daily
life'.
First Nations culture. Importance of FN culture was assessed by
asking "How important are traditional cultural events in your
life?" Response options were 'very important',
'somewhat important', 'not very important', and
'not important'.
Living in balance. Youth were asked how often they were in balance
physically, emotionally, mentally and spiritually. Four response options
for each aspect were anchored by 'almost none of the time' and
'all of the time'.
School attendance. Responses were grouped as 'yes' or
'no' based on school attendance.
Chronic conditions. Youth were asked whether they had 20 different
chronic conditions, not including allergies. The number was summed and
categorized as '0', '1', and '[greater than or
equal to]2' chronic conditions.
Family factors
Family structure. Parental structure at home was grouped as:
'living with both biological parents', ' living with one
biological parent', or 'living with no biological
parents'. The number of people living within the household
(excluding the respondent) was grouped as '<3', '3 or
4', '5 or 6', or '[greater than or equal to]7'.
Family socio-economic status. Parents' /guardians'
highest level of education, determined by the education level of the
most educated parent, was grouped as '<high school',
'high school graduate', or 'any post-secondary
education'.
Family culture. Youth were asked "Who helps you in
understanding your culture?" Responses included: parents,
grandparents, aunts/uncles, and other relatives; these were summed as
'0 relatives', '1 relative', '2
relatives', or '[greater than or equal to]3 relatives'.
Community factors
Community size. Respondents were considered to live within a small
(<300 people), a medium-sized (300-1,499 people), or a large
([greater than or equal to]1,500 people) FN community.
Community culture. Youth were asked "Who helps you understand
your culture?", with the following list provided: school teachers,
community elders, and other community members. Responses were summed as
'0', '1', '2', and '[greater than or
equal to]3' community members.
Community challenges. Youth reported whether or not their community
was facing challenges in education, alcohol and drug use, housing, loss
of culture, lack of employment, destruction of natural environment, poor
health, lack of funding, lack of control, and gang activity. Responses
were summed as '0 or 1', '2 or 3', '4 or
5', and '6 or more' community challenges.
Community strengths. Participants were asked "What are the
main strengths of your community?" Responses were placed into
'yes' or 'no' groups based on whether the
participants checked off each of the following areas: good leisure/
recreation facilities, natural environment, and community health
programs.
Physical activity
Youth were asked to report whether they had participated in 20
different common physical activities over the 12 months prior to the
survey, including activities that reflect FN culture and tradition
(e.g., berry picking, hunting/trapping, fishing, canoeing/ kayaking).
For each activity, they reported on frequency and typical duration of
participation. This information was used to estimate typical weekly
minutes of MVPA. Because bowling and berry picking fall below the
moderate intensity range (e.g., <4 times higher than resting energy
expenditure), (16) these activities were removed from the MVPA
calculation. Youth were placed into two groups based on degree of
adherence to the MVPA guideline of 60 min per day: 'physically
inactive' and 'physically active'. (17) Finally, to
examine PA participation through a cultural lens, 'yes' and
'no' groups were created with respect to participation in at
least one of the following traditional FN physical activities: berry
picking, hunting/trapping, fishing, and canoeing/kayaking.
Statistical analysis
We conducted analyses using IBM SPSS Complex Samples, version 22.
All analyses took into account the multi-stage stratified design of the
RHS by incorporating the design information into the models to adjust
for the disproportionate and cluster sampling. Initially, we calculated
descriptive statistics. Next, we used bivariate logistic regression
analysis to determine whether each of the individual, family and
community independent variables predicted each of the PA dependent
variables (e.g., accumulate [greater than or equal to]60 min/day of
MVPA, participate in traditional physical activities). We then conducted
unconditional multivariate logistic regression analysis. We used three
steps to determine the final model. First, we added all of the
individual-level factors to the model. These factors were only retained
for the second step (i.e., adding family factors) and third step (i.e.,
adding community factors) if their p-values were less than or equal to
0.20. Because the analyses were exploratory, we selected a p [less than
or equal to] 0.20 to ensure that we did not exclude variables in the
model that could have achieved significance, but only after controlling
for other variables in subsequent steps.
RESULTS
Descriptive characteristics
Table 1 provides a description of FN youth. Averaged over a year,
65% of FN youth reported engaging in an average of [greater than or
equal to]60 min/ day of MVPA and 48% reported engaging in at least one
traditional FN PA in a year.
Correlates of participation in [greater than or equal to]60 min/day
of MVPA
The multivariate logistic regression analysis (Table 2) revealed
that the adjusted odds ratios of participating in [greater than or equal
to]60 min/day of MVPA were higher in youth who were male (OR = 1.47),
had 1 chronic condition (OR = 1.55), attended school (OR = 1.50), used a
FN language most often in their daily life (OR = 1.54), and lived in
balance physically most (OR = 1.72) or all of the time (OR = 2.22).
As for the family factors (Table 3), the adjusted odds ratios of
participating in [greater than or equal to]60 min/day of MVPA were
higher in youth with parents who graduated high school (OR = 1.63) or
had some post-secondary education (OR = 1.28) and youth who had 3 or
more relatives helping them understand their culture (OR = 1.85).
At the community level, the multivariate analysis results in Table
4 show that the adjusted odds ratios for participating in [greater than
or equal to]60 min/day of MVPA were higher in youth who reported that
their community had 6 or more challenges (OR = 1.60) and youth who
perceived that the leisure/recreation facilities were a strength of
their community (OR = 1.48).
Correlates of participation in traditional First Nations physical
activities
As shown in Table 2, the adjusted odds ratios for engaging in
traditional FN physical activities were higher in youth who were male
(OR = 2.16), understand (OR = 1.57) and often use (OR = 1.55) a FN
language, live in balance spiritually most (OR = 1.43) or all of the
time (OR = 1.68), and were lower in older youth (OR = 0.73).
At the family level, the adjusted odds ratios of engaging in
traditional FN physical activities were higher in youth with one (OR =
1.34), two (OR = 1.55), or [greater than or equal to]3 relatives (OR =
1.71) helping them understand their culture. Youth living with one
biological parent had lower odds (OR = 0.66) of engaging in traditional
FN physical activities (Table 3).
The most relevant community factors associated with participation
in traditional FN physical activities were community size, perceived
natural environment, and perceived health programs of the community (p
[less than or equal to] 0.05; Table 4). Youth who lived in communities
with 300-1499 people (OR = 1.45) and with <300 people (OR = 2.30) had
a higher adjusted odds of engaging in traditional FN activities than
youth who lived in communities with [greater than or equal to]1,500
people.
DISCUSSION
When averaged across all days of the year, 65% of FN youth report
accumulating at least 60 min/day of MVPA. This figure should be
interpreted with caution as it may not mean that most FN youth are
meeting current Canadian (17) or global (18) PA guidelines, which
recommend 60 min of MVPA on a daily basis. Until PA is measured
objectively in FN youth, true levels of daily PA will remain uncertain.
(19)
The proportion of FN youth who participated in [greater than or
equal to]60 min/day of MVPA was higher among males and those with fewer
([less than or equal to]1) chronic conditions. These findings are
consistent with the mainstream literature. (19,20) We also found that FN
youth who reported feeling physically balanced 'most of the
time' or 'all of the time' were more likely to
participate in [greater than or equal to]60 min/day of MVPA than those
who feel physically balanced 'almost none of the time'. A
similar, albeit non-significant, pattern in the multivariate analyses
was noted for the mental, spiritual and emotional aspects of health.
Living in balance is an important indicator of wellness for FN peoples
and our findings are consistent with previous research showing that
youth who live in balance are more likely to participate in regular PA.
(4) In turn, evidence suggests that youth who regularly participate in
PA and sport benefit physically, emotionally, intellectually and
socially, (21-23) further reinforcing the notion of PA as culturally
meaningful "good medicine". (5)
The connection between PA and culture was further supported by our
finding at the family level, that youth with three or more relatives
helping them understand their culture were more likely to participate in
[greater than or equal to]60 min/day of MVPA than youth with fewer than
three relatives helping them understand their culture. This finding
suggests that family support for culture could be related to family
support for PA, which would align with the mainstream literature showing
that youth with family support for PA are typically more likely to be
physically active. (20)
When asked to identify the main challenges their communities were
currently facing, youth selected from a list of ten community-level
challenges, including lack of education and training opportunities,
alcohol and drug abuse, housing, loss of culture, lack of employment,
destruction of natural environment and resources, poor health, lack of
funding, lack of control, and gang activity. Youth identifying six or
more challenges in their community were more likely to participate in
[greater than or equal to]60 min/day of MVPA in comparison to youth who
reported that their community had one or no challenge. Although
seemingly counterintuitive, it may be that communities with more
challenges try to offer more PA-related opportunities and programs to
counter the community challenges. In support of this notion, we found
that FN youth who perceived leisure/ recreation facilities as a strength
of their community were more likely to participate in [greater than or
equal to]60 min/day of MVPA in comparison to youth who did not report
leisure/recreation facilities as a strength of their community.
Almost half of FN youth reported engaging in at least one
traditional FN PA (i.e., berry picking, hunting/trapping, fishing, and
canoeing/kayaking) in the previous year. Youth who were younger, male,
had knowledge of a FN language, and who reported feeling spiritually
balanced 'most of the time' or 'all of the time'
were more likely to engage in traditional FN physical activities. The
relationship between culture and physical expressions of the body is
recurrent and strong in some youth, possibly reflecting the use of
traditional FN activities as a way to reclaim cultural identity and to
address the disenfranchising effects of colonial oppression upon the
well-being of FN people. (1-3)
The number of relatives who help youth understand their culture was
important for involvement in traditional FN physical activities. Family
is central in traditional Aboriginal culture (24) and may play an
especially critical role in enhancing youth involvement in traditional
FN physical activities.
Youth living in small to medium communities (i.e., fewer than 1,500
people) were more likely to have engaged in traditional FN physical
activities than youth living in larger communities. It may be that there
is a stronger sense of community and more conformity among community
members in less-populated areas.25 It is intuitive that youth who
perceived the natural environment as a strength were more likely to have
engaged in traditional FN physical activities (i.e., berry picking,
hunting/ trapping, fishing, and canoeing/kayaking), given that these
activities occur in nature. Participation in traditional FN physical
activities may represent a salient way for youth to achieve balance in
health and well-being. Previous evidence suggests that the integration
of cultural practices and teachings in PA and sport can address the
negative influences of colonization, offering a space for healing from
intergenerational trauma (2,3,5) and an opportunity to promote youth
living in balance during the critical developmental stage of
adolescence. (26)
Consistent with the current findings, previous research on barriers
to PA in Aboriginal youth identifies the influences as multi-level. (15)
Our findings confirm the relevance of examining correlates for overall
and traditional PA involvement from an ecological lens. (20) Influences
on PA involvement by FN youth were found at each of the three ecological
levels considered. The theme of culture was found to cut across all
levels, confirming the importance of this construct for the examination
of, and eventual intervention upon, PA and well-being among FN youth.
Overall, the magnitude of the associations examined was weak to
modest and some limitations might be at play. Self-reported PA is known
to be over-reported and only modestly correlated to objectively measured
PA. (27) Thus, it is likely that the proportion of the population
meeting the [greater than or equal to]60 min/day MVPA target was lower
than reported. Specificity about the types of traditional activities
performed was also lost because response options were grouped. In
addition, given that the "participation in traditional PA"
measure could reflect as little as once a year participation in a
traditional activity, it should be noted as a limitation. Future studies
should expand the list of traditional FN activities to reflect the
variety of same (e.g., adding traditional dancing, drumming, tanning
hides, etc.).
Despite these limitations, the current study provides new evidence
for associations between PA in FN youth and several correlates at
diverse ecological levels. Future work is needed to examine additional
predictors of PA among youth living in FN communities.
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Received: May 1, 2014
Accepted: November 9, 2014
Lucie Levesque, PhD, [1] Ian Janssen, PhD, [1,2] Fei Xu, PhD, [3]
First Nations Information Governance Centre [3]
Author Affiliations
[1.] School of Kinesiology and Health Studies, Queen's
University, Kingston, ON
[2.] Department of Public Health Sciences, Queen's University,
Kingston, ON
[3.] First Nations Information Governance Centre, Ottawa, ON
Correspondence: Lucie Levesque, School of Kinesiology and Health
Studies, Queen's University, Kingston, ON K7L 3N6, Tel:
*^613-533-6000, Ext. 78164, E-mail:
[email protected]
Source of funding: Funding was provided by the First Nations
Information Governance Centre.
Conflict of Interest: Lucie Levesque and Ian Janssen received
consulting fees from the First Nations Information Governance Centre.
Fei Xu is employed by the First Nations Information Governance Centre.
Table 1. Unweighted N and % for all variables included in the
analyses
Variable Unweighted N %
Individual-level
variable
Age, years
12-14 2326 50.0
15-17 2498 50.0
Sex
Female 2476 48.7
Male 2361 51.3
Physical activity
[greater than 2917 65.0
or equal to]
60 min/day of
moderate-to-
vigorous
activity
Participate in 2276 47.7
traditional
First Nations
activities
Number of chronic
conditions
0 3392 71.6
1 906 18.4
[greater than 456 10.1
or equal to] 2
Attend school
No 465 12.3
Yes 4329 87.7
Knowledge of First
Nations language
Do not understand 2039 43.7
or speak
Understand but do 1566 34.9
not use most
often
Understand and 996 21.4
use most often
in daily life
Importance: First
Nations culture
Not important 259 5.5
Not very important 507 8.8
Somewhat important 1884 40.2
Very important 1985 45.5
Live in balance
physically
Almost none of 286 6.6
the time
Some of the time 872 18.4
Most of the time 1894 39.5
All of the time 1638 35.5
Live in balance
emotionally
Almost none 440 10.1
of the time
Some of the time 1106 24.5
Most of the time 1830 38.7
All of the time 1290 26.6
Live in balance
mentally
Almost none of 660 15.5
the time
Some of the time 863 18.9
Most of the time 1752 37.0
All of the time 1375 28.6
Live in balance
spiritually
Almost none 647 14.0
of the time
Some of the time 1142 25.2
Most of the time 1651 35.8
All of the time 1203 25.0
Family-level
variable
Parental structure
Live with no 791 16.4
biological parents
Live with 1 2224 45.6
biological parent
Live with both 1821 38.2
biological parents
# People in household
(excluding youth)
[greater than or 736 18.7
equal to] 7
5-6 1129 24.3
3-4 1945 38.2
< 3 1012 18.8
Family-level variable
Parental education
< High school 1725 41.7
graduate
High school graduate 1178 25.2
[greater than or 1550 33.1
equal to] Some
post-secondary
# Relatives who help
youth understand
culture
0 954 18.1
1 1752 39.9
2 953 18.5
[greater than or 1177 23.5
equal to] 3
Community-level
variable
Community size
[greater than or 590 7.3
equal to] 1500
people
300-1499 people 2585 49.6
< 300 people 1662 43.1
# Community members
who help youth
understand culture
0 2566 55.8
1 1467 27.6
2 569 11.6
[greater than or 234 5.0
equal to] 3
# Community challenges
perceived by youth
0 or 1 1324 25.5
2 or 3 1412 27.6
4 or 5 939 19.9
6 or more 1130 27.0
Leisure/recreation
facilities a
strength of
community
No 3893 79.9
Yes 912 20.1
Natural environment
a strength of
community
No 4112 85.9
Yes 693 14.1
Community health
programs a
strength of
community
No 3563 72.6
Yes 1242 27.4
Table 2. Individual/level factors associated with participation
in [greater than or equal to] 60 min/day of moderate/to/vigorous
PA and with participation in traditional First Nations physical
activities in 12/17 year old youth participants of the 2008/10
First Nations Regional Health Survey
Individual- Participation in [greater than or equal to]
level variable 60 min/day of MVPA
% * Unadjusted OR Adjusted OR
(95% CI) (95% CI)
([dagger]) ([double dagger])
Age, years
12-14 64.9 1 (referent) 1 (referent)
15-17 65.0 1.00 (0.84-1.26) 1.06 (0.86-1.29)
Sex
Female 60.9 1 (referent) 1 (referent)
Male 68.7 1.41 (1.16-1.72)# 1.47 (1.19-1.83)#
Number of chronic
conditions
[greater than 59.7 1 (referent) 1 (referent)
or equal to] 2
1 68.1 1.44 (1.01-2.05)# 1.55 (1.07-2.24)#
0 65.3 1.27 (0.94-1.71)# 1.37 (1.00-1.89)
Attend school
No 54.9 1 (referent) 1 (referent)
Yes 66.5 1.64 (1.25-2.13)# 1.50 (1.11-2.02)#
Knowledge: First
Nations language
Do not understand 62.6 1 (referent) 1 (referent)
nor speak
Understand, do not 64.5 1.09 (0.88-1.34) 1.18 (0.95-1.45)
use most often
Understand, use 71.5 1.50 (1.19-1.89)# 1.54 (1.19-1.99)#
most often
Importance: First
Nations culture
Not important 63.7 1 (referent)
Not very important 62.2 0.94 (0.62-1.41)
Somewhat important 64.2 1.02 (0.69-1.50)
Very important 67.0 1.16 (0.78-1.72) N/A
Live in balance
physically
Almost none of 52.1 1 (referent) 1 (referent)
the time
Some of the time 52.2 1.00 (0.67-1.52) 1.04 (0.66-1.64)
Most of the time 66.0 1.79 (1.22-2.62)# 1.72 (1.11-2.68)#
All of the time 72.7 2.46 (1.67-3.62)# 2.22 (1.42-3.47)#
Live in balance
emotionally
Almost none of 58.3 1 (referent)
the time
Some of the time 58.8 1.02 (0.73-1.42
Most of the time 68.4 1.55 (1.14-2.10))#
All of the time 68.9 1.58 (1.05-2.37)# N/A
Live in balance
mentally
Almost none of 56.7 1 (referent)
the time
Some of the time 56.1 0.98 (0.68-1.39)
Most of the time 68.8 1.68 (1.27-2.23)#
All of the time 70.9 1.86 (1.34-2.59# N/A
Live in balance
spiritually
Almost none of 55.7 1 (referent)
the time
Some of the time 59.3 1.16 (0.83-1.62)
Most of the time 69.7 1.83 (1.33-2.51)#
All of the time 69.5 1.82 (1.30-2.55)# N/A
Individual- Participation in traditional First Nations
level variable physical activities
% * Unadjusted OR Adjusted OR
(95% CI) (95% CI)
([dagger]) ([double dagger])
Age, years
12-14 51.4 1 (referent) 1 (referent)
15-17 43.9 0.74 (0.62-0.88)# 0.73 (0.61 -0.87)#
Sex
Female 39.2 1 (referent) 1 (referent)
Male 55.8 1.96 (1.66-2.32)# 2.16 (1.81-2.57)#
Number of chronic
conditions
[greater than 52.4 1 (referent) N/A
or equal to] 2
1 46.4 0.79 (0.61 -1.01)
0 51.6 0.97 (0.71-1.32)
Attend school
No 43.4 1 (referent) N/A
Yes 48.5 1.23 (0.96-1.58)
Knowledge: First
Nations language
Do not understand 41.5 1 (referent) 1 (referent)
nor speak
Understand, do not 53.0 1.59 (1.31-1.92)# 1.57 (1.22-1.97)#
use most often
Understand, use 53.8 1.64 (1.33-2.03)# 1.55 (1.28-1.92)#
most often
Importance: First
Nations culture
Not important 43.0 1 (referent) N/A
Not very important 42.4 0.98 (0.70-1.37)
Somewhat important 44.7 1.07 (0.80-1.43)
Very important 52.3 1.45 (1.08-1.95)#
Live in balance
physically
Almost none of 35.3 1 (referent) N/A
the time
Some of the time 41.7 1.31 (0.96-1.90)
Most of the time 46.3 1.58 (1.11-2.24)#
All of the time 54.6 2.20 (1.52-3.19)#
Live in balance
emotionally
Almost none of 48.3 1 (referent) N/A
the time
Some of the time 42.9 0.81 (0.58-1.11)
Most of the time 48.6 1.01 (0.74-1.39)
All of the time 50.4 1.09 (0.74-1.61)
Live in balance
mentally
Almost none of 43.8 1 (referent) N/A
the time
Some of the time 44.4 1.03 (0.80-1.32)
Most of the time 47.3 1.15 (0.90-1.47)
All of the time 52.6 1.43 (1.09-1.87)#
Live in balance
spiritually
Almost none of 37.2 1 (referent) 1 (referent)
the time
Some of the time 44.5 1.35 (1.00-1.82)# 1.28 (0.96-1.71)
Most of the time 49.6 1.66 (1.25-2.20)# 1.43 (1.08-1.88)#
All of the time 53.9 1.97 (1.50-2.60)# 1.68 (1.27-2.23)#
* % of participation in [greater than or equal to] 60 min/day in
MVPA and in First Nations traditional physical activities.
([dagger]) Unadjusted odds ratio (95% confidence interval).
([double dagger]) Adjusted odds ratio (95% confidence interval).
Adjusted for other individual/level, family and community
factors. N/A = not applicable as variable not included in final
model.
Bold numbers indicate statistically significant odds ratios (p <
0.05).
Note: The significant odds ratios (p < 0.05) are indicated with #.
Table 3. Family/level factors associated with participation in
[greater than or equal to] 60 min/day of moderate/to/vigorous PA
and with participation in traditional First Nations physical
activities in 12/17 year old youth participants of the 2008/10
First Nations Regional Health Survey
Family variable Participation in [greater than or equal
to] 60 min/day of MVPA
% * Unadjusted OR Adjusted OR
(95% CI) (95% CI)
([dagger]) ([double dagger])
Parental structure
Live with no 59.2 1 (referent) N/A
biological
parents
Live with 1 65.0 1.28 (0.99-1.66)
biological
parent
Live with both 67.3 1.42 (1.10-1.85)#
biological
parents
# People in
household
(excluding
youth)
[greater than 63.8 1 (referent) N/A
or equal to] 7
5-6 65.7 1.08 (0.84-1.39)
3-4 64.1 1.01 (0.79-1.29)
< 3 66.8 1.14 (0.87-1.50)
Parental education
< High school 60.4 1 (referent) 1 (referent)
graduate
High school 69.8 1.52 (1.25-1.84)# 1.63 (1.31-2.03)#
graduate
[greater than 67.2 1.34 (1.06-1.70)# 1.28 (1.00-1.62)#
or equal to]
Some post-
secondary
# Relatives who
help youth
understand
culture
0 59.8 1 (referent) 1 (referent)
1 60.0 1.01 (0.79-1.30) 0.90 (0.76-1.28)
2 65.6 1.29 (0.96-1.73) 1.12 (0.81-1.56)
[greater than 76.4 2.18 (1.63-2.94)# 1.85 (1.31-2.63)#
or equal
to] 3
Family variable Participation in traditional First Nations
physical activities
% * Unadjusted OR Adjusted OR
(95% CI) (95% CI)
([dagger]) ([double dagger])
Parental structure
Live with no 49.8 1 (referent) 1 (referent)
biological
parents
Live with 1 44.6 0.77 (0.61-0.96)# 0.66 (0.52-0.83)#
biological
parent
Live with both 51.3 0.94 (0.74-1.19) 0.80 (0.64-1.00)
biological
parents
# People in
household
(excluding
youth)
[greater than 49.1 1 (referent) N/A
or equal to] 7
5-6 46.9 0.91 (0.74-1.14)
3-4 48.3 0.97 (0.78-1.19)
< 3 46.7 0.91 (0.71-1.15)
Parental education
< High school 45.9 1 (referent) N/A
graduate
High school 48.0 1.09 (0.91 -1.31)
graduate
[greater than 49.1 1.14 (0.93-1.39)
or equal to]
Some post-
secondary
# Relatives who
help youth
understand
culture
0 39.6 1 (referent) 1 (referent)
1 45.5 1.27(1.03-1.58)# 1.34 (1.07-1.69)#
2 49.9 1.52(1.19-1.94)# 1.55 (1.19-2.02)#
[greater than 55.9 1.93 (1.52-2.46)# 1.71 (1.32-2.21)#
or equal
to] 3
* % of participation in [greater than or equal to] 60 min/day
MVPA and in First Nations traditional physical activities.
([dagger]) Unadjusted odds ratio (95% confidence interval).
([double dagger]) Adjusted odds ratio (95% confidence interval).
Adjusted for other individual-level, family, and community
factors.
N/A = not applicable as variable not included in final model.
Bold numbers indicate statistically significant odds ratios
(p < 0.05).
Note: Thesignificant odds ratios (p < 0.05) are indicated with #.
Table 4. Community/level factors associated with participation in
[greater than or equal to] 60 min/day of moderate/to/vigorous PA
and with participation in traditional First Nations physical
activities in 12/17 year old youth participants of the 2008/10
First Nations Regional Health Survey
Community variable Participation in [greater than or equal
to] 60 min/day of MVPA
% * Unadjusted OR Adjusted OR
(95% CI) (95% CI)
([dagger]) ([double dagger])
Community size
[greater than 63.8 1 (referent) N/A
or equal to]
1500 people
300-1499 people 66.5 1.12 (0.91-1.39)
< 300 people 61.1 0.89 (0.67-1.18)
# Community members
who help youth
understand
culture
0 61.2 1 (referent) N/A
1 67.2 1.30 (1.01-1.67)#
2 70.6 1.52 (1.13-2.06)#
[greater than 80.6 2.64 (1.55-4.50)#
or equal to] 3
# Community
challenges
perceived by
youth
0 or 1 58.7 1 (referent) 1 (referent)
2 or 3 66.3 1.38 (1.10-1.74)# 1.30 (1.00-1.70)#
4 or 5 63.6 1.23 (0.89-1.71) 1.24 (0.90-1.72)
6 or more 70.2 1.66 (1.27-2.17)# 1.60 (1.20-2.14)#
Leisure/recreation
facilities a
strength of
community
No 62.6 1 (referent) 1 (referent)
Yes 74.2 1.72 (1.34-2.20)# 1.48 (1.12-1.95)#
Natural environment
a strength of
community
No 64.6 1 (referent) N/A
Yes 67.5 1.14 (0.87-1.49)
Community health
programs a
strength of
community
No 63.2 1 (referent) N/A
Yes 69.6 1.33 (1.09-1.63)
Community variable Participation in traditional First Nations
physical activities
% * Unadjusted OR Adjusted OR
(95% CI) (95% CI)
([dagger]) ([double dagger])
Community size
[greater than 43.2 1 (referent) 1 (referent)
or equal to]
1500 people
300-1499 people 50.0 1.32 (1.11-1.56)# 1.45 (1.19-1.76)#
< 300 people 58.5 1.85 (1.42-2.42)# 2.30 (1.17-3.17)#
# Community members
who help youth
understand
culture
0 42.7 1 (referent) 1 (referent)
1 52.3 1.47 (1.23-1.77)# 1.11 (0.74-1.66)
2 58.1 1.89 (1.47-2.38)# 1.74 (1.31-2.30)#
[greater than 54.8 1.63 (1.06-2.51)# 1.42 (1.18-1.72)#
or equal to] 3
# Community
challenges
perceived by
youth
0 or 1 43.5 1 (referent) N/A
2 or 3 49.1 1.25 (1.01-1.54)#
4 or 5 45.8 1.10 (0.85-1.42)
6 or more 51.8 1.39 (1.11-1.75)#
Leisure/recreation
facilities a
strength of
community
No 46.8 1 (referent) N/A
Yes 51.6 1.21 (0.99-1.48)
Natural environment
a strength of
community
No 45.8 1 (referent) 1 (referent)
Yes 60.0 1.78 (1.38-2.29)# 1.55 (1.20-2.00)#
Community health
programs a
strength of
community
No 45.0 1 (referent) 1 (referent)
Yes 55.3 1.51 (1.26-1.81) 1.40 (1.17-1.67)
* % of participation in [greater than or equal to] 60 min/day
MVPA and in First Nations traditional physical activities.
([dagger]) Unadjusted odds ratio (95% confidence interval).
([double dagger]) Adjusted odds ratio (95% confidence interval).
Adjusted for other individual-level, family, and community
factors.
N/A = not applicable as variable not included in final model.
Bold numbers indicate statistically significant odds ratios (p
[less than or equal to] 0.05).
Note: significant odds ratios (p [less than or equal to] 0.05)
are indicated with #.
