Social Support and Peer Norms Scales for Physical Activity in Adolescents

Guidelines from the Centers for Disease Control and Prevention (CDC),1 US Department of Health and Human Resources (USDHHS),2 and the World Health Organization (WHO)3 call for children and adolescents to attain at least 60 minutes of moderate to vigorous physical activity (MVPA) each day, but only 16.3% of US adolescents aged 12-17 years achieve this recommendation.4 Moreover, physical activity (PA) declines dramatically from childhood to adolescence.5 Girls, especially those residing in urban areas, have lower levels of PA, compared to boys.6,7 Regular PA in adolescence helps control weight, build healthy bones and muscles, reduce anxiety and stress, increase self-esteem, and improve blood pressure, blood sugar, cardiovascular fitness, and cholesterol levels.8 Therefore, there is a critical need to increase urban adolescent girls’ PA to achieve the Healthy People 2020 objective of increasing the proportion of adolescents meeting daily PA recommendations to 20.2%.9 Understanding the correlates of adolescent PA, particularly among urban girls, is essential for designing PA interventions that effectively meet the needs of a specific group. Evidence has been consistent in supporting family social support10,11 and peer social support,12,13 as significant indicators of adolescents’ MVPA. The majority of previous studies use a separate scale to measure adolescents’ social support from a specific source, such as a mother, father, sibling, or friend.14-16 This approach not only increases the participant response burden due to the need to answer multiple measures of social support for PA for each source of support, but also may overlook important sources of social support, such as teachers, coaches, or non-family members. Alternative family situations, such as those involving 2 adults of the same sex (eg, mother and grandmother), require consideration. Moreover, scales including only 3 or 4 items to assess social support for PA may be inadequate for assessing all of the various forms of social support.11,12 Given the important impact that multiple forms of social support can have on adolescents’ predisposition to PA, a reliable and valid measure of overall social support for PA that includes items addressing both instrumental assistance (eg, provision of transportation) and emotional encouragement (eg, praise), as defined by the Health Promotion Model,17 is needed to provide an accurate assessment of adolescents’ perceptions of the total assistance they receive for PA. In addition to social support, evidence supports that perceived peers can drive health-promoting behaviors,18 such as adolescents’ PA.19-21 Despite the importance of peer norms on PA, only 2 studies were noted that included a scale for measuring adolescents’ peer norms for PA.19,20 One study used a scale with only one item to measure friends’ attitudes or beliefs about PA that mainly addressed acceptance of the behavior: my friends would approve of my being physically active.19 In the other study, the scale measuring adolescents’ peer norms for PA included only 2 items with one measuring beliefs or attitudes and the other assessing prevalence of behavior, but yielded a Cronbach's alpha of only .46.20 Therefore, there is a need for more comprehensive, valid and reliable measures of peer norms for adolescent PA. Developing comprehensive, yet easy-to-complete measures that are reliable and valid for assessing social support and peer norms is an essential step toward designing effective interventions to promote a physically active lifestyle among adolescents. Therefore, the purpose of this study was 2-fold: (1) to evaluate the psychometric properties of a Social Support and Peer Norms Scale in 5th-7th grade girls living in urban areas; and (2) to examine any correlation between social support and peer norms.