Active commuting to school in Spanish youth: prevalence, methodological advances and promotion in the school setting

Abstract

Background | Active commuting to/from school (ACS) and independent mobility (IM) are behaviours that occurs at least twice every weekday in all the young people. However, despite their multiple benefits for the individual and for the society, a growing number of studies have reported the decline in the prevalence of ACS and IM among children and adolescents in the last decades. Given that ACS and IM are presented as a feasible form of reducing sedentary time (ST) and increasing physical activity (PA) levels and, in addition, it can be integrated into individuals’ routines every weekday, it is of interest promoting active and independently commuting behaviors from the schools. Objectives | Three main objectives are addressed in this Thesis: (i) to study the prevalence of ACS and IM among Spanish chidren and adolescents; (ii) to explore the assessment of the ACS, and iii) to implement and examine the effects of a school-based cycling intervention on adolescent´s commuting behaviours. Methods | The study designs included in this Thesis are six cross-sectional studies, one systematic review and one randomized controlled trial. This Thesis encompasses data from the PACO Study. Self-reported questionnaries are used to quantify usual and daily mode of commuting to/from school. ActiGraph GT3X+ accelerometers attached to the right hip, Qstarz Global Positioning System (GPS) attached to the left hip and selfreported commuting diaries are used to quantify the PA behaviours. The statistical analysis used were binary and logistic regressions, multilevel logistic regression models, multinomial logistic mixed model, analysis of covariance (ANCOVA), and Bland & Altman plots. Results | In regards to the objective 1, this Thesis (i) provides a stable pattern in the rates of ACS during 2010-2017 among Spanish children and adolescents; (ii) describes higher rates of IM among Spanish adolescents than Spanish children; and (iii) observes higher rates of ACS over the transition from preprimary education to primary education and from primary education to compulsory secondary education among Spanish youth. Relative to the objective 2, the current Thesis (iv) remarks that future studies should ask about usual and daily mode of commuting to/from school to know mode and frecuency of commuting in adolescents; and (v) finds that self-reported commuting diaries may be a useful tool to know commuting times in adolescents. Regarding to the objective 3, this Thesis (vi) designs and implements a schoolbased intervention to promote cycling to school in Spanish adolescents; (vii) shows that walking mode to/from school is associated with lower ST and higher daily PA levels in adolescents across the PA domains (i.e., commuting, school, out-of-school, entire day, entire day without commuting); and (viii) demonstrates that a 4-week cycling intervention reduces commuting ST in Spanish adolescents, while no effect is observed on usual and daily mode of commuting to/from school and commuting PA levels. Conclusions | The findings from this International Doctoral Thesis provides the prevalence of ACS and IM among Spanish children and adolescents during 2010-2017, and across the entire school-life. Moreover, it provides methodological recommendatios to accurately assess the ACS behaviour, and finally, it remarks the importance of promoting ACS to reduce the sedentarism and increase the PA of the adolescents.