Testing the Physical Activity Transition Model Among Children and Adolescents in Low- and Middle-Income Countries: A...

Area of Science:

• Public Health
• Urban Planning
• Pediatric Health

Background:

• Rapid urbanization in low- and middle-income countries (LMICs) presents challenges to physical activity (PA) levels.
• The PA transition model suggests urban environments may decrease PA, particularly among youth.

Purpose of the Study:

• To review and synthesize evidence on the PA transition among children and adolescents in LMICs.
• To assess the impact of urbanization on PA levels in young populations within LMICs.

Main Methods:

• Systematic review and meta-analysis of 84 studies involving over 530,000 participants aged 3-19 years across 29 LMICs.
• Comparison of device-based moderate- to vigorous-intensity PA between urban and rural participants, stratified by income classification.
• Assessment of study and evidence quality using established tools (AXIS, JBI, GRADE).

Main Results:

• 68% of studies with significant urban-rural differences reported higher PA in rural youth.
• Urban youth in LMICs accumulated approximately 10 fewer minutes of moderate- to vigorous-intensity PA daily compared to rural youth.
• Lower PA levels were observed in urban participants from low and lower-middle income countries compared to rural counterparts.

Conclusions:

• Urbanization is associated with decreased physical activity in children and adolescents in LMICs, supporting the PA transition model.
• Urban growth necessitates proactive urban planning to promote active living environments for youth.
• Policymakers and public health professionals should prioritize creating child- and adolescent-friendly active cities.