Influence of body mass index, gender, and Hispanic ethnicity on physical activity in urban children

Childhood obesity is a growing health concern both globally and within the United States. In the last 30 years, obesity rates, defined as greater than the 95th percentile for Body Mass Index (BMI) for age-gender, have more than doubled in children 2–5 years old and in adolescents 12–19 years old. Rates among children 6–11 years old have tripled (Lutfiyya, Garcia, Dankwa, Young, & Lipsky, 2008; Wang & Lobstein, 2006). Although the rate of overweight and obesity is increasing for all children in the United States, there is some evidence that suggests that racial and ethnic minorities and those from a lower socioeconomic status (SES) are at greater risk for being overweight or obese (Ball et al., 2008; Oude et al., 2009). According to the Institute of Medicine, up to 24% of African American and Hispanic children are obese (Dehghan, Akhtar-Danesh, & Merchant, 2005). Among school-age children in 2003-2004, 42.9% of Mexican American children 6–11 years old and 40% of African American children 6–11 years old were overweight (85th–94th percentile for BMI for age-gender; Gentile et al., 2009). Furthermore, the highest prevalence of childhood obesity among boys has been observed in Hispanics, whereas the highest prevalence among girls was found in African Americans (Wang & Lobstein, 2006). In Los Angeles, California, 18% of Hispanic children are overweight, and 22.9% of 7th grade Hispanics do not meet the overall goals set by the state for physical fitness. In addition, 24.6% of Hispanics live below the federal poverty level (L.A. Children’s Planning Council, 2008). Suggested factors for the cause of childhood obesity include improper nutrition practices, decreased child activity levels, underlying genetic and metabolic factors, socioeconomic disadvantages, altered child temperament, and family neglect (Lutfiyya et al., 2008). Adopting and maintaining healthy lifestyle behaviors can help overweight boys and girls manage their weight and reduce obesity-related health risks. The American Dietetic Association (ADA) recently completed a comprehensive evidence analysis of behavioral factors that are associated with childhood overweight. Adequate evidence (Grade II) showed that a major factor placing children at risk for overweight is reduced physical activity (PA; Dencker, Thorsson, Karlsson, Linden, Svensson, et al., 2006; Dencker, Thorsson, Karlsson, Linden, Eiberg, et al., 2006; Gilbride, 2006). Studies have reported that the greatest decrease in PA occurs during early to late adolescence (i.e., 3rd–10th grade), primarily among girls and minorities (Bradley, McMurray, Harrell, & Deng, 2000). Children are more active than adults, but their activity levelsdecline as they move toward adolescence, and significant numbers of young people do not participate in recommended levels ofPA. The 2009 Youth Risk Behavior Surveillance Study (YRBS; Eaton et al., 2010) provides documentation ofthe inadequate levels of PA among high-school-ageyouth (grades 9–12); 23.1% of all high-school students surveyed did not participate in at least 60 minutes of physical activity on any day. Of these, the prevalence was higher in students in the 12th grade (25.6%) and 11th grade (22.9%) as compared with those in the 9th grade (21.8%), and among African American (32.1%) and Hispanic (23.9%) students as compared to White students (20.3%). In addition, the prevalence of using computers 3 or more hours per day on other than school-related business was higher among 9th-grade (28.7%) than 10th-grade (25.5%), 11th-grade (23.4%), and 12th-grade (21.2%) students, and higher among African American (30.4%) and Hispanic (25.7%) than White (22.1%) students (Eaton et al., 2010). As a result, efforts need to be focused on increasing PA opportunities among early adolescents to develop healthy living behaviors and decrease excessive weight gain. The school setting has a primary role in the promotion of PA among normal-weight children and overweight children (Thomas, 2006). In particular, physical education class (PE) and participating in intramural sports teams have received increased attention relative to their importance and potential in providing both normal-weight students and overweight students with appropriate amounts of time in PA (Taras et al., 2004). With the growing problem of obesity in children and adolescents, much attention has focused on BMI measurement programs in schools, especially those programs conducted by trained personnel, such as a nurse (Nihiser et al., 2007). BMI percentiles are the most commonly used indicator to assess the size and growth patterns of individual children in the United States. Some states, such as Arkansas, have initiated BMI measurement programs in recent years. In California, students participate in physical fitness testing that assesses BMI along with other fitness-related variables (Nihiser et al., 2007). There are few published reports that examine PA levels of early adolescents’ participation in PE class and intramural team sports, especially among urban, Hispanic adolescents (Babey, Hastert, Yu, & Brown, 2008; Duke, Human, & Heitzler, 2003). While some studies have identified health disparities within pediatric obesity, few studies have examined the PA health behaviors of specific racial and ethnic groups, especially Hispanics, living in urban and low-income settings, and related this to weight status (e.g., body mass index) and gender, nor have these studies sufficiently discussed the implications for nursing practice for assessment and prevention of pediatric obesity. The purpose of the current study was to examine the associations between gender and Hispanic ethnicity, the behavioral factors of PA, the attendance of school PE classes, participation in sports teams, and weight status among urban, Hispanic early adolescents ages 7–11 years (1st-5th grade) at a Los Angeles, California, elementary school. This community-based participatory research (CBPR) study was conducted through a collaboration of nurses, public health practitioners, and school administrators in an effort to understand PA behaviors among this underserved community to provide information on ways that nurses and other healthcare providers could promote physical activity as a means to prevent childhood obesity in Hispanic child populations and, with the support of the community, to assist the researchers in developing future culturally appropriate interventions.