Little is known about the role of active school travel (AST) on mental health among adolescents. Thus, this study aimed to explore the AST-depression association among adolescents aged 12-15 years from 26 low-and middleincome countries (LMICs). Data from the Global School-based Student Health Survey were analyzed in 51,702 adolescents [mean (SD) age 13.8 (1.0) years; 49.3% boys). Both depressive symptoms and AST were assessed by a single question self-reported measure, respectively. Participants who reported having 5 days or above were considered as AST. Multivariable logistic regression analysis (accounting for sampling weights) was performed while controlling for gender, age, physical activity, sedentary behavior, and food insecurity, and a countrywide meta-analysis was undertaken. The prevalence of depressive symptoms and AST were 30.1% and 37.0%, respectively. Compared with those not having AST, adolescents with AST were less likely to have self-reported depressive symptoms (OR = 0.88, 95%CI: 0.85-0.93) regardless of gender. Countrywide meta-analysis demonstrated that having AST versus not having AST was associated with 12% lower odds for depressive symptoms (OR = 0.88; 95%CI: 0.82-0.94) but with a moderate between-country heterogeneity (I 2 = 59.0%). Based on large samples of adolescents from LMICs, it would be expected that AST may play a critical role in preventing adolescent depression worldwide. However, it is necessary to consider more country-specific This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The present study explored heterogeneity in the association between engaged living (i.e., social integration and absorption) and problematic Internet use (PIU). This study included 641 adolescents from four junior-senior high schools of Guangzhou, China. Besides the standard linear regression analysis, mixture regression analysis was conducted to detect certain subgroups of adolescents, based on their divergent association between engaged living and PIU. Sex, age, and psychological need were further compared among the latent subgroups. The results showed that a mixture regression model could account for more variance of PIU than a traditional linear regression model, and identified three subgroups based on their class-specific regression of PIU to engaged living. For the High-PIU class, lower social integration and higher absorption were associated with increased PIU; for the Medium-PIU class, only high social integration was linked with the increase of PIU. For the Low-PIU class, no relation between engaged living and PIU were found. Additionally, being male or having a lower level of satisfied psychological needs increased the link between engaged living and PIU. The results indicated a heterogeneous relationship between engaged living and PIU among adolescents, and prevention or intervention programs should be tailored specifically to subgroups with moderate or high levels of PIU and to those with lower levels of psychological needs’ satisfaction, as identified by the mixture regression model.
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