Association between pediatric counseling and after school physical activity in children: A cross-sectional study

Introduction. Physical activity during childhood is essential for health; however, current recommendations are often not met. The effectiveness of pediatric advice in clinical practice is uncertain. Objective. To evaluate the association between pediatric advice and after-school physical activity in children, and to analyze the influence of demographic, anthropometric, and family factors. Population and methods. Observational, cross-sectional study. Children aged 7 to 14 years were included. The association between a history of pediatric counseling and the practice of after-school physical activity was evaluated. Pediatric counseling was defined as a history of receiving recommendations from a pediatrician aimed at promoting physical activity and was obtained through parental self-report. Univariate analysis and multivariate logistic regression were performed. The nonlinear relationship with body mass index (BMI) was explored, and a sensitivity analysis was conducted using 1:1 propensity score matching (PSM). Results. A total of 823 children (mean age 10.2 ± 2.3 years) were included; 35.2% engaged in physical activity. No significant association was observed between pediatric advice and physical activity (OR 1.38; 95%CI 0.98-1.94; p = 0.061). Male gender and parental physical activity during childhood were significantly associated with higher levels of physical activity. A nonlinear relationship between BMI and physical activity was observed. In the PSM analysis, the association remained nonsignificant (OR 1.49; 95%CI 0.99-2.22; p = 0.053). Conclusion. Pediatric counseling in routine clinical practice is not independently associated with physical activity in children. Structured, multi-component strategies are needed.