Recent trends in physical activity correlates among children and adolescents in China A systematic review
Article Sidebar
Main Article Content
Abstract
China, one of the most densely populated emerging nations, is confronted with an escalating problem of inadequate physical activity among its children and teenagers. This review systematically examines literature from the past five years to identify the latest trends in factors related to physical activity among Chinese kids and teenagers, aiming to provide information for formulating policies and intervention strategies tailored to China's national context. We searched six electronic databases (PubMed, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and ERIC) for studies published between January 2019 and January 2024. A total of 30 articles met the inclusion criteria, with four employing longitudinal designs and three using objective tools to assess physical activity. Sample sizes ranged from 255 to 93,600 participants, with 23 studies involving more than 1,000 participants. The findings indicate that, compared to other countries, young people's physical activity in China is more strongly associated with parental support, physical exercise, family structure, and neighbourhood safety. Furthermore, research examining the correlation between school surroundings and physical activity is scarce. Future interventions should prioritize family-related factors and strengthen the collaboration between families and schools.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Each author warrants that his or her submission to the Work is original and that he or she has full power to enter into this agreement. Neither this Work nor a similar work has been published elsewhere in any language nor shall be submitted for publication elsewhere while under consideration by Journal of Human Sport and Exercise (JHSE). Each author also accepts that the JHSE will not be held legally responsible for any claims of compensation.
Authors wishing to include figures or text passages that have already been published elsewhere are required to obtain permission from the copyright holder(s) and to include evidence that such permission has been granted when submitting their papers. Any material received without such evidence will be assumed to originate from the authors.
Please include at the end of the acknowledgements a declaration that the experiments comply with the current laws of the country in which they were performed. The editors reserve the right to reject manuscripts that do not comply with the abovementioned requirements. The author(s) will be held responsible for false statements or failure to fulfill the above-mentioned requirements.
This title is licensed under a Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).
You are free to:
Share — copy and redistribute the material in any medium or format.
Adapt — remix, transform, and build upon the material.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
-
NonCommercial — You may not use the material for commercial purposes.
-
ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
- You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
- No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
How to Cite
References
Aadland, E., Kvalheim, O. M., Hansen, B. H., Kriemler, S., Ried-Larsen, M., Wedderkopp, N., Sardinha, L. B., Møller, N. C., Hallal, P. C., Anderssen, S. A., Northstone, K., & Andersen, L. B. (2020). The multivariate physical activity signature associated with metabolic health in children and youth: An International Children's Accelerometry Database (ICAD) analysis. Preventive Medicine, 141, 106266. https://doi.org/10.1016/j.ypmed.2020.106266
An, M., Chen, T., Zhou, Q., & Ma, J. (2021). Paternal and maternal support of moderate-to-vigorous physical activity in children on weekdays and weekends: A cross-sectional study. BMC Public Health, 21(1), 1776. https://doi.org/10.1186/s12889-021-11730-8
Bao, Y., Gao, M., Luo, D., & Zhou, X. (2023). Urban Parks-A Catalyst for Activities! The Effect of the Perceived Characteristics of the Urban Park Environment on Children's Physical Activity Levels. Forests, 14, 423. https://doi.org/10.3390/f14020423
Biddle, S. J. H., Ciaccioni, S., Thomas, G., & Vergeer, I. (2019). Physical activity and mental health in children and adolescents: An updated review of reviews and an analysis of causality. Psychology of Sport and Exercise, 42, 146-155. https://doi.org/10.1016/j.psychsport.2018.08.011
Bila, W. C., Romano, M. C. C., Dos Santos, L. L., da Silva, V. R., Capanema, F. D., Pfrimer, K., Ferriolli, E., Alves, N. M. C., Campos, C. G., Carlos, F. M., Dos Santos, M. E. S. M., & Lamounier, J. A. (2023). Body fat, cardiovascular risk factors and polymorphism in the FTO gene: Randomized clinical trial and different physical exercise for adolescents. Jornal De Pediatria, 99(2), 139-146. https://doi.org/10.1016/j.jped.2022.07.004
Borde, R., Smith, J. J., Sutherland, R., Nathan, N., & Lubans, D. R. (2017). Methodological considerations and impact of school-based interventions on objectively measured physical activity in adolescents: A systematic review and meta-analysis. Obesity Reviews, 18(4), 476-490. https://doi.org/10.1111/obr.12517
Craggs, C., Corder, K., Van Sluijs, E. M. F., & Griffin, S. J. (2011). Determinants of Change in Physical Activity in Children and Adolescents. American Journal of Preventive Medicine, 40(6), 645-658. https://doi.org/10.1016/j.amepre.2011.02.025
Ding, D., Ramirez Varela, A., Bauman, A. E., Ekelund, U., Lee, I.-M., Heath, G., Katzmarzyk, P. T., Reis, R., & Pratt, M. (2020). Towards better evidence-informed global action: Lessons learnt from the Lancet series and recent developments in physical activity and public health. British Journal of Sports Medicine, 54(8), 462-468. https://doi.org/10.1136/bjsports-2019-101001
Dobbins, M., Husson, H., DeCorby, K., & LaRocca, R. L. (2013). School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. The Cochrane Database of Systematic Reviews, 2013(2), CD007651. https://doi.org/10.1002/14651858.CD007651.pub2
Fairclough, S. J. (2021). Adolescents' digital screen time as a concern for health and well-being? Device type and context matter. Acta Paediatrica, 110(7), 1985-1986. https://doi.org/10.1111/apa.15843
Fan, X., Zhu, Z., Zhuang, J., Liu, Y., Tang, Y., Chen, P., & Cao, Z. (2019). Gender and age differences in the association between living arrangement and physical activity levels among youth aged 9-19 years in Shanghai, China: A cross-sectional questionnaire study. BMC Public Health, 19(1), 1030. https://doi.org/10.1186/s12889-019-7383-z
Foster, H. E., Scott, C., Tiderius, C. J., Dobbs, M. B., & Members of the Paediatric Global Musculoskeletal Task Force. (2020). Improving musculoskeletal health for children and young people-A 'call to action'. Best Practice & Research. Clinical Rheumatology, 34(5), 101566. https://doi.org/10.1016/j.berh.2020.101566
Gao, F., Guo, Q., Wang, B., Cao, S., Qin, N., Zhao, L., Jia, C., & Duan, X. (2022). Distributions and determinants of time spent outdoors among school-age children in China. Journal of Exposure Science & Environmental Epidemiology, 32(2), 223-231. https://doi.org/10.1038/s41370-021-00401-w
Gao, W., Zhang, Y., Wu, D., Dong, Y., Liu, N., & Wang, H. (2022). Compliance with Health-Related Behaviors Guidelines and Its Relationship with Multiple Factors in Preschool Children Aged 3-6 Years: A National Cross-Sectional Survey in China. International Journal of Environmental Research and Public Health, 19(3), Article 3. https://doi.org/10.3390/ijerph19031262
Guo, Z., Qi, C., Yang, J., Xu, Y., & Li, S. (2023). How family structure influences middle-school students' involvement in physical exercise and their academic achievement in China. Humanities and Social Sciences Communications, 10(1), Article 1. https://doi.org/10.1057/s41599-023-01636-8
Guo, Z., Xu, Y., Li, S., & Qi, C. (2022). Association between Urban Built Environments and Moderate-to-Vigorous Physical Activity of Adolescents: A Cross-Lagged Study in Shanghai, China. International Journal of Environmental Research and Public Health, 19(15), Article 15. https://doi.org/10.3390/ijerph19158938
Hong, J.-T., Chen, S.-T., Tang, Y., Cao, Z.-B., Zhuang, J., Zhu, Z., Chen, P., & Liu, Y. (2020). Associations between various kinds of parental support and physical activity among children and adolescents in Shanghai, China: Gender and age differences. BMC Public Health, 20(1), 1161. https://doi.org/10.1186/s12889-020-09254-8
Huang, C., Yang, Y., Shi, G., Hua, Y., Lai, W., Zheng, X., Lu, C., & Guo, L. (2023). Associations between emotional/behavioral problems and physical activity among Chinese adolescents: The mediating role of sleep quality. Current Psychology. https://doi.org/10.1007/s12144-023-05397-0
Huang, W., Shi, X., Wang, Y., Li, X., Gao, P., Lu, J., & Zhuang, J. (2021). Determinants of student's physical activity: A 12-month follow-up study in Ningxia province. BMC Public Health, 21(1), 512. https://doi.org/10.1186/s12889-021-10525-1
Huang, X., Lu, G., Yin, J., & Tan, W. (2021). Non-linear associations between the built environment and the physical activity of children. Transportation Research Part D: Transport and Environment, 98, 102968. https://doi.org/10.1016/j.trd.2021.102968
Jiang, W., Sun, L., He, Y., Liu, W., Hua, Y., Zheng, X., Huang, C., Liu, Q., Xiong, L., & Guo, L. (2023). Association between physical activity and depressive symptoms in adolescents: A prospective cohort study. Psychiatry Research, 329, 115544. https://doi.org/10.1016/j.psychres.2023.115544
Kandola, A., Lewis, G., Osborn, D. P. J., Stubbs, B., & Hayes, J. F. (2020). Depressive symptoms and objectively measured physical activity and sedentary behaviour throughout adolescence: A prospective cohort study. The Lancet Psychiatry, 7(3), 262-271. https://doi.org/10.1016/S2215-0366(20)30034-1
Ke, Y., Shi, L., Peng, L., Chen, S., Hong, J., & Liu, Y. (2022). Associations between socioeconomic status and physical activity: A cross-sectional analysis of Chinese children and adolescents. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.904506
Laird, Y., Fawkner, S., Kelly, P., McNamee, L., & Niven, A. (2016). The role of social support on physical activity behaviour in adolescent girls: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 79. https://doi.org/10.1186/s12966-016-0405-7
Lei, L., Zhang, H., & Wang, X. (2020). Adolescent Sports Behavior and Social Networks: The Role of Social Efficacy and Self-Presentation in Sports Behavior. Complexity, 2020, e4938161. https://doi.org/10.1155/2020/4938161
Liang, F., Fu, J., Xu, Y., Wang, Y., Qiu, N., Ding, K., Zeng, J., Moore, J. B., & Li, R. (2022). Associations of Social Jetlag with Dietary Behavior, Physical Activity and Obesity among Chinese Adolescents. Nutrients, 14(3), Article 3. https://doi.org/10.3390/nu14030510
Liu, J., Zeng, M., Wang, D., Zhang, Y., Shang, B., & Ma, X. (2022). Applying Social Cognitive Theory in Predicting Physical Activity Among Chinese Adolescents: A Cross-Sectional Study With Multigroup Structural Equation Model. Frontiers in Psychology, 12, 695241. https://doi.org/10.3389/fpsyg.2021.695241
Liu, Y., Ge, X., Li, H., Zhang, E., Hu, F., Cai, Y., & Xiang, M. (2023). Physical activity maintenance and increase in Chinese children and adolescents: The role of intrinsic motivation and parental support. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1175439
Love, R., Adams, J., & van Sluijs, E. M. F. (2019). Are school-based physical activity interventions effective and equitable? A meta-analysis of cluster randomized controlled trials with accelerometer-assessed activity. Obesity Reviews, 20(6), 859-870. https://doi.org/10.1111/obr.12823
Lu, C., Shen, T., Huang, G., & Corpeleijn, E. (2020). Environmental correlates of sedentary behaviors and physical activity in Chinese preschool children: A cross-sectional study. Journal of Sport and Health Science, 11(5), 620-629. https://doi.org/10.1016/j.jshs.2020.02.010
Lu, C., Stolk, R. P., Sauer, P. J. J., Sijtsma, A., Wiersma, R., Huang, G., & Corpeleijn, E. (2017). Factors of physical activity among Chinese children and adolescents: A systematic review. The International Journal of Behavioral Nutrition and Physical Activity, 14(1), 36. https://doi.org/10.1186/s12966-017-0486-y
Lv, H., & Wang, R. (2023). Association between the built environment and moderate to vigorous leisure-time physical activity among Suzhou adolescents: A cross-sectional study. BMC Public Health, 23(1), 1313. https://doi.org/10.1186/s12889-023-16243-0
Lyu, B., Zhang, D., & Yang, Y. (2019). The Influence of Family Structure Differences on Physical Activity of Children and Adolescents in China--Taking Social Capital and Health Behavior as Mediating Factors. https://doi.org/10.21203/rs.2.12709/v1
Mendonça, G., Cheng, L. A., Mélo, E. N., & de Farias Júnior, J. C. (2014). Physical activity and social support in adolescents: A systematic review. Health Education Research, 29(5), 822-839. https://doi.org/10.1093/her/cyu017
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ, 339, b2535. https://doi.org/10.1136/bmj.b2535
Morton, K. L., Atkin, A. J., Corder, K., Suhrcke, M., & van Sluijs, E. M. F. (2016). The school environment and adolescent physical activity and sedentary behaviour: A mixed-studies systematic review. Obesity Reviews, 17(2), 142-158. https://doi.org/10.1111/obr.12352
National Bureau of Statistics of China. (2024, January 17). Degree of urbanization in China in selected years from 1980 to 2023. Statista. Retrieved from [Accessed 2025, January 28]: https://www.statista.com/statistics/270162/urbanization-in-china/
Pannekoek, L., Piek, J. P., & Hagger, M. S. (2013). Motivation for physical activity in children: A moving matter in need for study. Human Movement Science, 32(5), 1097-1115. https://doi.org/10.1016/j.humov.2013.08.004
Qiu, N., Gao, X., Zhang, X., Fu, J., Wang, Y., & Li, R. (2021). Associations between Psychosocial Variables, Availability of Physical Activity Resources in Neighborhood Environment, and Out-of-School Physical Activity among Chinese Adolescents. International Journal of Environmental Research and Public Health, 18(12), Article 12. https://doi.org/10.3390/ijerph18126643
Qurban, H., Wang, J., Siddique, H., Morris, T., & Qiao, Z. (2019). The mediating role of parental support: The relation between sports participation, self-esteem, and motivation for sports among Chinese students. Current Psychology, 38(2), 308-319. https://doi.org/10.1007/s12144-018-0016-3
Ren, Z., Hu, L., Yu, J. J., Yu, Q., Chen, S., Ma, Y., Lin, J., Yang, L., Li, X., & Zou, L. (2020). The Influence of Social Support on Physical Activity in Chinese Adolescents: The Mediating Role of Exercise Self-Efficacy. Children, 7(3), Article 3. https://doi.org/10.3390/children7030023
Rutten, C., Boen, F., & Seghers, J. (2013). The Relation Between Environmental Factors and Pedometer-Determined Physical Activity in Children: The Mediating Role of Autonomous Motivation. Pediatric Exercise Science, 25, 273-287. https://doi.org/10.1123/pes.25.2.273
Shao, T., & Zhou, X. (2023). Correlates of physical activity habits in adolescents: A systematic review. Frontiers in Physiology, 14. https://doi.org/10.3389/fphys.2023.1131195
Shi, M., Shi, Y., Zhao, Z., Zhai, X., & Fan, X. (2022). The effect of family structure on physical activity levels among children and adolescents in Western China in the era of COVID-19. BMC Public Health, 22(1), 2072. https://doi.org/10.1186/s12889-022-14432-x
Sirard, J. R., Laska, M. N., Patnode, C. D., Farbakhsh, K., & Lytle, L. A. (2010). Adolescent physical activity and screen time: Associations with the physical home environment. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 82. https://doi.org/10.1186/1479-5868-7-82
Smith, J. J., Eather, N., Morgan, P. J., Plotnikoff, R. C., Faigenbaum, A. D., & Lubans, D. R. (2014). The health benefits of muscular fitness for children and adolescents: A systematic review and meta-analysis. Sports Medicine (Auckland, N.Z.), 44(9), 1209-1223. https://doi.org/10.1007/s40279-014-0196-4
Soares, R., Brasil, I., Monteiro, W., & Farinatti, P. (2023). Effects of physical activity on body mass and composition of school-age children and adolescents with overweight or obesity: Systematic review focusing on intervention characteristics. Journal of Bodywork and Movement Therapies, 33, 154-163. https://doi.org/10.1016/j.jbmt.2022.09.004
Su, D. L. Y., Lee, A. S. Y., Chung, J. S. K., Tang, T. C. W., Capio, C. M., Zhang, L., & Chan, D. K. C. (2023). Significant others and students' leisure-time physical activity intention: A prospective test of the social influence in sport model. Journal of Exercise Science and Fitness, 21(3), 275-279. https://doi.org/10.1016/j.jesf.2023.04.002
Wang, H., Fang, Y., Zhang, Y., & Zou, H. (2024). Effects of School Physical Education on the Exercise Habits of Children and Adolescents: An Empirical Analysis Using China Health and Nutrition Survey Data. Journal of School Health, 94(1), 23-36. https://doi.org/10.1111/josh.13391
Wang, X., & Jiang, Y. (2023). Influencing Factors of Sports Activities of Urban Migrant Children Based on Intelligent Evaluation. Sustainability, 15(5), Article 5. https://doi.org/10.3390/su15054692
Wang, Y., He, G., Ma, K., Li, D., & Wang, C. (2022). Preschool Children's Physical Activity and Community Environment: A Cross-Sectional Study of Two Cities in China. International Journal of Environmental Research and Public Health, 19(22), Article 22. https://doi.org/10.3390/ijerph192214797
Xia, M., Hu, P., & Zhou, Y. (2020). How parental socioeconomic status contribute to children's sports participation in China: A cross-sectional study. Journal of Community Psychology, 48(8), 2625-2643. https://doi.org/10.1002/jcop.22439
Yang, X., Leung, A., Jago, R., Yu, S., & Zhao, W. (2020). Physical activity and sedentary behaviors among Chinese children: Recent trends and correlates. https://doi.org/10.21203/rs.3.rs-38071/v1
Yao, C. A., & Rhodes, R. E. (2015). Parental correlates in child and adolescent physical activity: A meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 10. https://doi.org/10.1186/s12966-015-0163-y
Zach, S., Zeev, A., Dunsky, A., Goldbourt, U., Shimony, T., Goldsmith, R., & Netz, Y. (2012). Adolescents' physical activity habits-Results from a national health survey. Child: Care, Health and Development, 39. https://doi.org/10.1111/j.1365-2214.2012.01392.x
Zeng, J., Qiu, N., Leitzelar, B. N., Fu, J., Wang, Y., Liang, F., Ding, K., Moore, J. B., Zou, Y., & Li, R. (2022). Parental Support Is Associated with Moderate to Vigorous Physical Activity among Chinese Adolescents through the Availability of Physical Activity Resources in the Home Environment and Autonomous Motivation. Children, 9(9), Article 9. https://doi.org/10.3390/children9091309
Zhou, Y., & Wang, L. (2019). Correlates of Physical Activity of Students in Secondary School Physical Education: A Systematic Review of Literature. BioMed Research International, 2019, e4563484. https://doi.org/10.1155/2019/4563484
Zhou, Z., Li, X., & Zhang, Z. (2023). The Peer Effect in Promoting Physical Activity among Adolescents: Evidence from the China Education Panel Survey. International Journal of Environmental Research and Public Health, 20(3), Article 3. https://doi.org/10.3390/ijerph20032480