While some studies have identified health disparities within pediatric obesity, few studies have examined the specific PA health behaviors of specific racial and ethnic groups living in urban and low-income settings, and related this to weight status among early adolescent populations. Due to the increase in prevalence of childhood obesity among Hispanic early adolescent populations, this study utilized the social ecologic model, a behavior theory, to understand PA behaviors of Hispanic elementary school children so that this data could guide nurses and other healthcare practitioners in creating future cultural and linguistically appropriate obesity prevention interventions for urban Hispanic children and their families. In terms of general intrapersonal factors, this study found 36.4% of the children to be overweight (BMI ≥85th percentile for age-gender). This is greater than the U.S. average of 22.9% (Lee et al., 2006
). These results are higher than other studies among urban, low-income Hispanic populations that found a lower overall prevalence (e.g. < 20%) of overweight and obese children (Silveira et al., 2006
). Further studies among Hispanic early adolescents are needed to fully understand why there is a high prevalence of overweight and obesity in this population.
As is common within the socio-ecological framework, several of the factors interrelate, and it is the interrelation of these factors that brings deeper insight into the understanding of obesity-related activities (e.g., PA; Fitzgerald & Spaccarotella, 2009
). In terms of the intrapersonal factor of age, the interpersonal factor of PA, and the community/institutional factor of participation in team sports, this study showed that younger Hispanic children participated in less physical activity including team sports activities. This finding is similar to the national studies that found that fewer children ages 9 to 13 years reported involvement in organized sports (Duke et al., 2003
). In terms of weight status, another intrapersonal factor, normal-weight children (BMI 5%-84%) had higher levels of PA, PE class attendance, and participated in three or more team sports, as compared to overweight (BMI > 85%) children. These findings are similar to previous studies among Hispanic elementary-school children that found that overweight students engage in less PA than non-overweight students (Byrd-Williams et al., 2007
In terms of gender, an intrapersonal factor, an important finding in this study is that more females had high levels of PA participation (interpersonal factor) even though they attended fewer PE classes (community/institutional factor). This is different from a study that found a higher participation in PA among males (43.7%) than females (25.6%; Butte, Puyau, & Adolph, 2007
). However, similar to another study, there were high levels of PE class attendance by students in the current research study, with the majority being male (Butte et al., 2007
). Increase in PA and PE class attendance may be due to the state board of education and local school district creating regulations about PA and attending PE classes that follow the recommendations by the AAP. For example, in 2009 the California State Department of Education adopted the Physical Education Framework for California Public Schools: Kindergarten through Grade Twelve
document that requires physical education instruction, based partially on the AAP and CDC recommendations (California State Board of Education, 2009); consequently this school has a daily PE requirement.
In relation to the joint intrapersonal and community/institutional factors of gender and team sports participation, the findings of gender differences in team sports participation is not surprising and is similar to previously reported data on team sports. Previous studies have also found gender differences in sports team activities, with males demonstrating a strong preference for participating in team sports (Hill & Cleven, 2005
; Kulinna, Martin, Lai, Kilber, & Reed, 2003
). One study found that girls in the 4th through 6th grades preferred to participate in activities that were not extremely vigorous or competitive and concluded that if team sports included activities such as aerobics, contemporary dance, or tennis, activities that female adolescents prefer, perhaps their rates of participation would increase (Hill & Cleven, 2005
Ethnicity (an interpersonal-level representation of culture in this study) was found to be related to weight status (an intrapersonal factor). This is similar to other studies that found that Hispanic children had higher rates of overweight as compared to White children (Springer et al., 2009
). Among Spanish-speaking children, disparities regarding activity were reported. While more Spanish-speaking students reported high levels of PE class attendance (community/institutional factor), more Spanish-speaking children reported low PA (interpersonal factor) and low levels of team sports participation (community/institutional factor). These results are similar to previous research that showed Spanish-speaking children were less likely to participate in PA as compared to English-speaking children (Springer et al., 2009
). Another study looked further within Hispanic groupings and found that first-generation, non-English speakers were half as likely to engage in regular PA and sports (Taverno, Rollins, & Francis, 2010
). Findings from this current study indicate important disparities in Hispanic children’s PA participation and the need for further research to examine obesity-related programs.
According to general studies on PA and children, several of these aforementioned behavioral findings including low levels of PA, participation in team sports, and attending PE classes, may be due to socio-ecologic-related barriers to PA and can lead to poor health outcomes among children and youth. For example, intrapersonal level (e.g., age, gender, weight status) barriers may include lack of knowledge about the health benefits of being physically active and lack of self-confidence and motivation to participate in physical activities (Rees et al.,2006
). Interpersonal barriers to PA may include lack of social support (e.g., from same-sex peers or families) in their physical activities. In addition, culture, or specifically acculturation, the process by which racial/ethnic groups adopt the cultural patterns of the dominant group (Satia-Abouta, Patterson, Neuhouser, & Elder, 2002
), can be a barrier at the interpersonal and the community/intuitional levels because culture and cultural preference can be seen as a part of the social environment within the family and in the community or school setting and can have a strong influence on the physical activities of a child. For example, similar to other studies (Springer et al., 2009
), in the current study, children who were less acculturated (e.g., Spanish speakers) were less likely to participate in PA and team sports.
Socioeconomic characteristics of schools can be community/institutional barriers to PA among underserved children. A national study that surveyed Hispanic parents of early adolescents concluded that key barriers to Hispanic children’s participation in PA included expenses related to PA programs (62.3%), issues with transportation to the PA programs (36.9%), and lack of PA opportunities in their communities (30.8%; Duke et al., 2003
). For example, due to financial burdens, underserved neighborhoods may offer fewer team sports programs and/or may have less access to adequate, safe space for children to play. In addition to an underserved community, urban schools may have less PA equipment (e.g., balls, jump ropes) to be used in physical activities. Consequently children do not engage in developmentally appropriate PA during recess or PE class (Girandola & Chin, 2004
), which may lead to increases in the prevalence of overweight and obese children. In order to decrease disparities in PA among urban Hispanic children, there must be an alleviation of these financial barriers associated with participation in PA in the community. More studies focusing on racial/ethnic minority groups, including qualitative or mixed qualitative and quantitative studies, need to be done to further understand the specific socio-ecologic-related PA barriers and solutions to the barriers of Hispanic elementary-school children. Additional recommendations to overcome these barriers are discussed in the Implications section of this paper.
Several study limitations must be acknowledged. The use of a standardized survey with prescribed questions limited the ability of the researchers to modify the questions or add to the questions and limited the opportunity to ask qualitative questions, which may have allowed the researchers to obtain a more in-depth understanding of some of the behavioral findings. The 2007 YRBS tool was originally intended for 6th- through 8th-grade students, and, although the implementation was approved by the CDC for use in this current age group and modified to adjust for the developmental stage of the participants, more studies should be done in this age group to determine reliability of the tool. The survey was conducted only on a sample set of children who attended this school and hence the results obtained in this setting cannot be applied to all the children of this age group in general. Generalizability of the results to groups of children of different ages and to other ethnic backgrounds may be limited; therefore, similar studies need to be conducted with a more culturally diverse sample.