HEALTH PROMOTION INTERNATIONAL
© Oxford University Press 2002. All rights reserved
Vol. 17, No. 1
Printed in Great Britain
School journeys and leisure activities in rural
and urban adolescents in Norway
ASTRID N. SJOLIE and FRODE THUEN
The Nordic School of Public Health, Göteborg, Sweden
SUMMARY
Health promotion measures in order to increase physical
activity should include environmental and policy approaches.
Studies in natural living environments such as rural and
urban areas may provide valuable information about
the effects of environmental factors on physical activity.
The present study was performed among 88 adolescents
living in one rural and one urban area in Norway, with particular focus on the availability of cycling tracks and walking trails. The study showed that both rural and urban
adolescents spent more time on sedentary activities, such
as watching TV/video and playing TV/data-games, than
on regular physical activity. No differences were observed
between the two groups in regard to activity patterns. However, the median distance the urban adolescents walked
or cycled to school was three times greater than the median
distance the rural adolescents walked or cycled to a bus
stop or to school. The urban adolescents also walked or
cycled more to regular activities than the rural ones. Positive
correlations were found between walking or cycling from
home to school and walking or cycling to regular activities.
In multiple regression analysis, urban area, female gender
and distance walked or cycled to school or bus stop predicted increased walking or cycling to activities. The results
confirm other studies on adolescents, showing that much
more time is spent on sedentary rather than on physical
activity. Knowledge is still lacking concerning predictors
of sedentary and general physical activity, but the results
indicate that access to cycling tracks and walking trails in
residential areas may increase both walking or cycling to
school and to leisure activities. A relevant strategy for health
promotion may therefore be to make cycling tracks and
walking trails accessible; some passive transport both to
school and to leisure activities may thus probably be replaced
by walking or cycling.
Key words: adolescents; environmental factors; physical activity
INTRODUCTION
There is a widespread belief that lifestyle in the
industrialized world is becoming increasingly
passive (Pate et al., 1995; Beaglehole and Bonita,
1999), and that economic development may
adversely affect health by reducing the level of
overall physical activity (Beaglehole and Bonita,
1999). Lack of physical activity may thus be
regarded as a risk factor for poor physical health
and for lack of well-being in adults and children
(Pate et al., 1995; Stronks et al., 1996; Morris and
Hardmann, 1997; Beaglehole and Bonita, 1999;
Sothern et al., 1999). Major health enhancing
effects have often been related to vigorous exercise.
However, recent investigations emphasize the
health benefits of moderate increases in daily activities and the development of active lifestyles. There
is evidence that small, frequent increases in
activities like walking produce health effects
(Pate et al., 1995).
Many efforts to influence physical activity have
been dominated by a medical approach focusing
on the individual level, typically as health education
measures or other persuasive approaches (Berlin
and Colditz, 1990; Bouchard et al., 1994).
However, from a health promotion perspective it
would be more efficient to develop policy and
21
22
A. N. Sjolie and F. Thuen
environmental approaches to physical activity.
Such approaches would be aimed at promoting
health and well-being in the general public, rather
than focusing on preventing coronary heart disease, e.g. among particular high-risk groups,
which has often been the aim. Recently, leading
public health authorities such as the US Surgeon
General have emphasized interventions that
include policy and environmental support in
order to promote physical activity (US Surgeon
General, 1996). Few studies have assessed the
effects of policy and environmental intervention
approaches on physical activity (King et al.,
1995). However, access to recreational facilities
appears to increase physical activity in leisure time
(Sallis et al., 1996), and environmental measures
have led to increased activity levels in a controlled community trial (Linenger et al., 1991).
Different living environments such as rural
versus urban areas, and the lifestyles in such
areas, can be considered natural experiments
for the influence of the environment on physical
activity. The large differences in spatial characteristics, and opportunities for recreational
activities in such areas, may create substantial
differences in the level of physical activity. In
fact, various Norwegian studies have found a
lower level of physical performance, measured
as muscle strength, aerobic capacity and joint
mobility, in rural adolescents compared with
those living in urban areas (Solstad, 1973;
Andersen et al., 1980; Ellingsen, 1999; Sjolie,
2000). One of the factors explaining these differences seems to be the extent to which the adolescents walk or cycle to school and regular
activities. Students who walked or cycled between
2 and 4 km to school had better aerobic capacity
than those walking shorter distances or those
using a school bus in a large Norwegian study
(Solstad, 1973). Furthermore, in a publication
prior to the present study, rural adolescents had
~20% less hip mobility and lower back extension
than the urban ones. In multivariate analyses,
negative associations were found between length
of the school bus journey, hip mobility and low
back extension. The main beneficial factor associated with physical performance was walking or
cycling to regular activities, which was positively
associated with hip mobility, lower back extension and lower back strength (Sjolie, 2000). Thus,
natural living environments in terms of rural and
urban areas may illuminate environmental as
well as lifestyle factors related to physical activity
among adolescents.
The aim of the present study was to explore
the activity patterns in groups of adolescents, to
study the associations among the activities, and
to investigate whether geographical area, access
to walking trails and school journeys predict
physical and sedentary activities. It was hypothesized that activity patterns would vary in accordance with existing facilities, and that long school
journeys and lack of walking trails would be associated with less physical activity.
METHODS
The inclusion criteria were all pupils in 8th and
9th grade (n = 105), who had lived for at least
3 years in two geographical areas in inland
Norway.
• A rural municipality, Rendalen. School authorities informed us that most pupils used the
school bus, due to lack of walking trails and
to school centralization (B. Momb, personal
communication).
• An urban area within a distance of 4 km from
Hanstad primary and junior secondary school
in Elverum community, 120 km from Rendalen.
The exclusion criterion was serious disease;
none were excluded. Fifty boys and 38 girls participated, making the response rate 84%. There
were no significant differences in response rate
or gender distribution between the two areas.
The mean age was 14.7 years, standard deviation
(SD) was 0.7, and the range spanned 14.1–16.1
years. The non-responders included two boys
and four girls in the rural area, and six boys and
five girls in the urban area. The materials have
been described in detail elsewhere (Sjolie, 2000).
Description of the areas
The unemployment rate was 4% in both communities, while the rate of receivers of social
welfare benefits was 2.5% in Rendalen versus
6.0% in Elverum (Informasjonshjulet, 1996). Data
particularly for the Hanstad area do not currently
exist. Land use maps were provided from community authorities, who also informed us about
the demography of the regions (G. Ulltveit-Moe,
personal communication; B. Momb, personal
communication). In the rural community there
were 0.3 km of walking trails, not situated by
the school, while there were 30 km of walking
trails in the urban community, of which 8 km
Activities in adolescents
were situated in the Hanstad area. The headmaster
and the teachers informed us that all families
owned cars, and that all pupils had access to
bikes. The total numbers of pupils were 180 in the
rural school and 430 in the urban school.
School journeys and socioeconomic status
Lists from the schools and the municipality
authorities provided the pupils’ addresses and
lengths of the school bus journeys (K. Skoglund,
personal communication; B. Momb, personal communication). Active school journeys (distances
walked/cycled to school or to bus stop) were
calculated from detailed land use maps obtained
from the municipality authorities, and doublechecked with information from pupils and teachers.
The information concerning being driven privately
to school was obtained both from the teachers
and the pupils, and double-checked. Socioeconomic
status was measured by parental occupation and
recorded according to the parent with the highest
level. These data were obtained by a questionnaire
answered by 90% of the rural fathers, 92% of the
rural mothers, 80% of the urban fathers and 90%
of the urban mothers. Occupations were classified
in seven categories according to a Norwegian
standard (National Bureau of Statistics, 1984): 7,
professional; 6, teacher, engineer; 5, subordinate
employee; 4, nurse; 3, farmer; 2, workman,
labourer, carpenter; 1, no occupation.
Leisure activities
Both areas provided good opportunities for
participating in forest touring, jogging, skiing,
skating, swimming, aerobics, horse riding, choirs
and orchestras. Scouting, handball and football
were only accessible in the urban area, where most
leisure activities were performed in the school
area or at two nearby activity centres, which were
connected to the school and the residential areas
by a network of walking trails. The rural area
had a rich musical tradition with several choirs
and orchestras. Skating, swimming, aerobics and
musical activities were performed in the school
area, while handball and football were accessible
in the neighbouring community. The distances
from home to the activities were obtained both
from the teachers and the pupils, and were
double-checked with the land use maps for both
areas.
Leisure activities were measured by a questionnaire (shown in the Appendix) that was based upon
23
Norwegian research of adolescents (Solstad,
1973; Oia, 1994). The pupils answered the questionnaire in the classroom in the presence of the
first author and a teacher in January 1997. The
questionnaire covered journeys to school and
to all types of regular weekly leisure activities,
types of activities, time spent on regular leisure
physical activity, time spent watching television
or on a computer including video and computer
games, and time spent on reading including homework. Inclusion criteria were current leisure
activities that had been performed regularly for
at least 2 months, and previous activities, finished
within the last 2 months and previously performed
regularly for at least 6 months. A subsample of
10 pupils answered the questions constructed
for this study twice with an interval of 3 weeks.
Correlations varied from 0.7 (participation in
forest touring, time spent on reading and on the
television/computer, transport modes to leisure
activities) to 0.9 (time spent and frequency of
physical activity, participation in jogging, skiing
and sport competitions).
Physical measurements
The height and weight of pupils were measured,
and body mass index (BMI) calculated as weight/
squared height, since a negative relationship
between obesity and physical activity seems to
be established (Strauss, 1999). The BMI was
20.8 and 20.3 for the rural and urban girls, and
20.2 and 20.6 for the rural and urban boys, respectively, without significant differences.
Statistical analyses
P values in bivariate analyses were estimated by
chi-square (χ2) tests, the student’s t-tests and correlation analyses (Pearson’s r). Multiple regression
analyses were performed to estimate the independent influence of variables after adjustment. Probability plots of the residuals were made, revealing
a normal distribution of the residuals in all analyses. The level of significance was set to p < 0.05.
The program Minitab version 13.1 was used.
RESULTS
The participants, their socioeconomic status and
school journeys are described in Table 1. The bus
journey each way to school was on average 18 km
for the rural pupils. The means and medians of
24
A. N. Sjolie and F. Thuen
Table 1: Age, gender and school journeys by area (n = 88)
Rural area
Mean (SD)
Age
Socioeconomic status 1–7
Girls
Boys
Present regular use of bus/car to school
Distance home to school (km)
School bus (km)
Walked/cycled to school or
to bus stop (km)
Median
14.7 (0.5)
Urban area
n (%)
15
3.5
Mean (SD)
14.7 (0.6)
Median
15
5
16 (42)
22 (58)
36 (94)
18.5 (15.9)
18.1 (16.0)
0.4 (0.5)
12.6
12
0.2
n (%)
,0.001
22 (44)
28 (56)
0
0.8 (0.8)
0
0.8 (0.8)
pa
0.6
,0.001
0.6
0.005
p values .0.2 are omitted.
a
t-tests were used for continous data and χ2 tests for categorical data.
Table 2: Weekly time spent on activities and weekly leisure transport distances by area (n = 88)
School bus (h)
Physical activity (h)
Television/computer (h)
Reading (h)
Walked/cycled to activities (km)
Car/bus to activities (km)
Rural area
Mean (SD)
Urban area
Mean (SD)
t-test
p value
4.2 (3.9)
9.1 (8.9)
17.8 (9.8)
6.4 (3.0)
1.0 (2.2)
26.6 (38.9)
0
8.9 (9.0)
15.1 (7.4)
8.6 (5.7)
10.3 (12.2)
12.2 (22.7)
0.2
0.02
,0.001
0.05
p values .0.2 are omitted.
active school journeys were 0.4 and 0.2 km in the
rural area versus 0.8 and 0.6 km in the urban
area, respectively. Twenty-five per cent of the
rural pupils lived within 4.5 km of the school.
None of the urban pupils reported being brought
regularly to and from school by car or bus, and
none of the rural pupils reported being brought
regularly by car from home to the bus stop.
Active school journeys were performed mostly
by walking in the rural area and mostly by cycling
in the urban area. The headmaster and the teachers
living in the urban area gave assurances that
no pupils in grades 8–9 had either been or were
regularly driven by bus or car to and from school
(K. Skoglund, personal communication). There
was a lower socioeconomic level in the rural area
than in the urban area. Time spent on activities,
and leisure transport distances according to area
are described in Table 2.
Weekly time spent on physical activity was
9 h and time spent watching television or on the
computer was 16 h for the whole group, without
significant geographical or gender differences.
The rural pupils spent 4 h every week on the
school bus. Rural adolescents walked or cycled
1.0 km weekly to regular activities compared
with 10.3 km among urban adolescents. Rural
adolescents were brought 26.6 km to regular
activities every week by car or bus, compared
with 12.2 km among urban adolescents. There
were no significant gender differences in the transport distances. Girls spent more time reading
than boys (9 h versus 7 h; p = 0.04). The specific
activity patterns according to area are described
in Table 3.
The main activities in the rural area were forest
touring, music, skiing, skating and jogging. Forest
touring, football, jogging and handball were the
main activities in the urban area. Other regular
activities were reported by 17% of the rural
adolescents and 10% of the urban adolescents. A
correlation analysis between sociodemographic
factors and activity data was performed. The
results are shown in Table 4.
Active school journey distance correlated negatively with school bus distance, and positively
with distance walked or cycled to activities. School
bus distance correlated negatively with distance
Activities in adolescents
25
Table 3: Numbers and percentages participating weekly in activities (minimum 45 min) by area (total n = 88).
Rural area
n (%)
Urban area
n (%)
χ2 test
p value
22 (58)
27 (71)
27 (71)
13 (34)
8 (21)
14 (37)
17 (45)
11 (29)
11 (29)
1 (3)
9 (24)
0
7 (18)
3 (8)
2 (5)
36 (58)
25 (50)
17 (34)
35 (70)
24 (48)
7 (14)
10 (20)
14 (28)
10 (20)
15 (30)
3 (6)
11 (22)
3 (6)
6 (12)
6 (12)
0.2
0.05
0.001
0.001
0.009
0.01
0.01
Regular physical activity more than three times a week
Manual work
Forest touring
Regular walking/cycling to activities
Sport competition
Skiing/slalom
Social musical performance
Jogging
Skating
Football
Tractor/scooter
Handball
Horse-riding
Aerobics
Swimming
0.001
0.02
0.002
0.07
p values .0.2 are omitted.
Table 4: Pearson’s r correlations between journeys, socioeconomic status and weekly activities (n = 88)
Walked/
cycled to
school
r
p
School bus
(km)
r
p
Physical
activity
(h)
r
p
Walked/
cycled to
activities
(km)
r
School bus (km)
–0.24 0.03
Physical activity (h)
0.03
–0.05
Walked/cycled to activities (km) 0.33 0.002 –0.31 0.003 0.06
Television/computer (h)
–0.06
0.12
–0.04
–0.15
Reading (h)
0.06
–0.23 0.03 –0.11
0.24
Car/bus to activities (km)
–0.11
0.28 0.008 0.25 0.02 –0.23
Socioeconomic status 1–7
0.15
–0.24 0.03
0.002
0.16
p
Television/
computer
(h)
r
p
Reading
(h)
r
p
Car/bus
(km)
r
p
0.2
0.03 0.002
0.03 –0.28 0.009 –0.13
0.1
0.02
0.22 0.05 –0.05
p values .0.2 are omitted.
walked or cycled to activities and with time spent
on reading. Distances walked or cycled and those
travelled by car or bus to activities were negatively correlated. The distance travelled by car or
bus to activities correlated positively with the
amount of time spent on regular physical activity,
and negatively with time spent watching television
or on a computer. No other correlates were
found for either time spent on regular physical
activity or on a television/computer. Positive
correlations were found between reading and
walking or cycling to activities. No significant
associations were found between socioeconomic
status and either time spent on physical activity
or time spent on a television/computer. Multiple
regression analyses are shown in Table 5.
Dependent variables were weekly activities—
time spent on regular physical activity, on a
television/computer or on reading—and distances
walked or cycled, or travelled by car or bus to
regular activities. Independent variables were
area, gender, socioeconomic status and school
journeys, adjusting for BMI. No significant
correlates were found for time spent on physical
activity or time spent on a television/computer.
Female gender predicted an increase of 2.4 h
reading and an increase of 5 km walking or
cycling to activities. Rural area predicted 8 km
less walking or cycling to activities, while an
increase of 1 km active school journey predicted
an increase of 5.3 km walking or cycling to
activities.
26
A. N. Sjolie and F. Thuen
Table 5: Associations between weekly activities and sociodemographic factors by multiple regression
analysesa (n = 88)
Sociodemographic factors
Urban area = 1, rural area = 2
Male = 1, female = 2
Socioeconomic status 1–7
Walked/cycled to school/bus stop (km)
School bus distance (km)
r-square
Physical
activity
(h)
TV/computer
(h)
B
p
B
p
3.4
–2.4
0.2
0.3
–0.06
5.6
0.1
0.2
3.0
–2.7
0.7
–0.5
0.04
9.0
0.2
Reading
(h)
B
–1.2
2.4
0.6
–0.4
–0.03
17.1
Walked/cycled
to activities
(km)
p
0.02
0.1
Car/bus to
activities
(km)
B
p
B
–8.0
5.0
–0.4
5.3
–0.008
32.5
0.004
0.02
4.9
–4.8
0.8
–1.4
0.5
8.2
0.004
p
0.1
B, B-coefficients. Empty cells indicate p . 0.2.
a
Adjusted for BMI.
DISCUSSION
The hypothesis that the activity patterns of
rural and urban adolescents were different was
not met either concerning time spent on regular
physical activity and a television/computer or concerning main physical activity preference. The
findings probably reflect the access of recreational
woodland in both areas and the similarities
between rural and urban adolescents in their
preferences, although the urban and rural adolescents also used facilities that were specific for
their areas. The activity patterns indicate a
common trend in both rural and urban areas:
9 h weekly spent on regular physical activity
is similar to findings from American studies
indicating adolescents spend 1–1.5 h a day in
moderate to vigorous physical activity (Craig
et al., 1996; Myers et al., 1996). The hypothesis of
less physical activity among rural adolescents
was, however, fulfilled in the sense that the rural
adolescents had a shorter active school journey
and walked/cycled less to activities than the
urban adolescents. The hypothesis of negative
associations between school bus journeys and
activities was also fulfilled by the inverse associations between school bus distances, active
school journeys and walking or cycling to
activities.
In both areas, time recorded as sedentary far
exceeded time spent on physical activity, confirming the results of other studies (Myers et al.,
1996; Simons-Mortons et al., 1997; Levin et al.,
1999). The large amount of weekly time spent on
a television/computer is similar to findings from
studies among adolescents in Russia (Levin et al.,
1999) and the US (Myers et al., 1996; Andersen
et al., 1998; Lindquist et al., 1999). The large
amounts of time spent on a television/computer
may seem unfortunate, since the amount of
time spent watching television has been shown to
be related to low back pain and obesity in
adolescents and children (Balague et al., 1994;
Andersen et al., 1998). No association between
time spent on a television/computer and physical
activity was observed. This is in keeping with
other studies (Balague et al., 1993; Lindquist
et al., 1999), suggesting that time spent on a television/computer does not compete with physical
activity, but varies independently of it.
In general the study indicates that the
rural–urban distinction does make a difference
as regard to the level of physical activity among
adolescents. Even though the difference was
quite modest, it probably also mirrors unplanned
walking or cycling and active transport to irregular
activities as well. These activities viewed together
may explain the differences in hip mobility and
lower back extension in the two samples (Sjolie,
2000). This is also in accordance with studies
indicating that even activities like 30 min of
walking daily produce health effects (Pate et al.,
1995), even when divided into periods of 5–10 min
(Coleman et al., 1999). The findings imply that in
areas where pupils have short or no active school
journeys, the schools should provide more
physical activity during school time, e.g. by taking
some lessons outdoors, and by making the
outdoor area for breaks attractive for a variety
of physical activities. These decisions should be
based on cooperation with the pupils to ensure
their involvement (Kalnins et al., 1992).
Activities in adolescents
It was mainly the bus journey and walking/
cycling to school and other activities that differentiated the rural and urban adolescents. These
factors underline the importance of the distance
and transportation mode to school and recreational
facilities. A policy implication would be that instead of offering a free school bus, local authorities should develop cycling tracks and walking
trails in order to increase walking and cycling to
school and other activities. This would be a policy
and environmental intervention that could
change the way of transportation from a passive
to an active journey for large groups of children
and adolescents, with the potential of substantially improving public health. The exchange of
passive bus journeys with active school journeys
may thus be an important health promotion task,
and may conform to at least three of the strategies
of the Ottawa charter (WHO, 1986): the trails
would validate a health-oriented public policy;
the environments would support physical activity;
and children and adolescents (and others) would
develop personal skills.
To illustrate this, a hypothetical calculation
was performed to investigate how many students
in the rural community would have been able to
come to school by walking or cycling if walking
trails had existed up to 4.5 km from the two
schools in the community. A total of 184 of the
215 pupils (86%) use a school bus at present, of
whom 92 live within 4.5 km of school. The percentage using a school bus could thus be reduced
to 43% if walking trails were accessible, and the
percentage walking or cycling to school could
increase from 14 to 57%. Therefore, building
walking trails and cycling tracks seems to be a
practical means of promoting more activity.
In keeping with this, empirical investigations
across different countries suggest that good
facilities may be important determinants of the
degree of physical activity within the population,
especially with regard to low and moderate levels
of activity (Rütten et al., 2001). Thus, children
and adolescents with low levels of physical
activity, being at risk of developing poor health,
may particularly profit from such environmental
support. Developing walking trails and cycling
tracks would probably also influence the level of
physical activity in other age groups, and may,
again, be particularly beneficial for those individuals otherwise engaged in a low or moderate
level of physical activity. There is also evidence
that physical activity in adolescence is continued
in adulthood (Barnekow-Bergkvist et al., 1996).
27
Hence, such measures may increase the chance
of affecting a large percentage of the underactive
population, of all ages, with potentially low costs
per person and great public health benefit.
Although the relatively small sample size is a
shortcoming in this study, the small size of the
schools may help to validate the information from
the teachers, e.g. concerning their knowledge of
the performance of the active school journeys
of the pupils. The similarities in time spent on
physical activity and on a television/computer in
this study compared with other studies (Craig
et al., 1996; Myers et al., 1996; Andersen et al.,
1998; Levin et al., 1999; Lindquist et al., 1999)
indicate that our sample may have some general
relevance. The findings may add valuable information to the issue of environmental factors as a
means of promoting physical activity, as it
appears that access to walking trails and cycling
tracks is substantially related to increased physical
activity. Furthermore, it is well established that
only a small increase in physical activity may
have positive health effects. Compared with the
traditional individual health education efforts,
which seem to have quite limited effects, environmental measures, such as building walking trails
and cycling tracks should be the option of choice.
Such a policy may contribute to a change in the
trends to increasing levels of driving to school
and work by car and bus, and decreasing levels
of walking to school and work, reported in
Scandinavian and British surveys (Vibe, 1993;
Lumsdon and Mitchell, 1999). This is in keeping
with a more general trend in public health,
sometimes described as a paradigm shift away
from the individual-oriented approaches towards
a more expansive model of health behaviour
change, that has greater impact (Schmidt et al.,
1995; Rütten et al., 2001). Thus, the current
knowledge provides an empirical-based direction
for a strategy in health promotion efforts in
relation to physical activity.
Address for correspondence:
Astrid N. Sjolie
Sjolisand
2450 Rena
Norway
E-mail: [email protected]
REFERENCES
Andersen, K. L., Seliger, V., Rytenfrantz, J. and Nesset, T.
(1980) Physical performance capacity of children in
28
A. N. Sjolie and F. Thuen
Norway. European Journal of Applied Physiology, 45,
155–166.
Andersen, R. E., Crespo, C. J., Bartlett, S. J., Cheskin, L. J.
and Pratt, M. (1998) Relationship of physical activity and
television watching with body weight and level of fatness
among children. Journal of the American Medical
Association, 279, 938–942.
Balague, F., Damidot, P., Nordin, M., Parnianpour, M.
and Waldburger, M. (1993) Cross-sectional study of the
isokinetic muscle trunk strength among school children.
SPINE, 18, 1199–1205.
Balague, F., Nordin, M., Skovron, M. L., Dutoit, G., Yee, A.
and Waldburger, M. (1994) Non-specific low-back pain
among schoolchildren: a field survey with analysis of some
associated factors. Journal of Spinal Disorders, 7, 374–379.
Barnekow-Bergkvist, M., Hedberg, G., Janlert, U. and
Jansson, E. (1996) Physical activity pattern in men
and women at the ages of 16 and 34 and development
of physical activity from adolescence to adulthood.
Scandinavian Journal of Medical Science in Sports, 6,
359–370.
Beaglehole, R. and Bonita, R. (1999) Public Health at the
Crossroads. Cambridge University Press, UK.
Berlin, J. A. and Colditz, G. (1990) A meta-analysis of
physical activity in the prevention of coronary disease.
American Journal of Epidemiology, 132, 612–628.
Bouchard, C., Shepherd, R. J. and Stephens, T. (1994)
Physical Activity, Fitness and Health: International
Proceedings and Consensus Statement. Human Kinetics,
Champaign, IL, USA.
Coleman, K. J., Raynor, H. R., Mueller, D. M., Cerny, F. J.,
Dorn, J. M. and Epstein, L. H. (1999) Providing
sedentary adults with choices for meeting their walking
goals. Preventive Medicine, 28, 510–519.
Craig, S., Goldberg, J. and Dietz, W. (1996) Psychosocial
correlates and physical activity among fifth and eighth
graders. Preventive Medicine, 25, 506–513.
Ellingsen, F. (1999) Kartlegging av styrke, bevegelighet,
koordinasjon og utholdenhet. Skoleelever i Akershus 1968
og 1997. (A survey comparing strength, mobility, coordination and endurance among school children in Akershus
in 1968 and 1997. Norwegian text.) The Norwegian
University of Sport and Physical Education, Oslo.
Informasjonshjulet (Community Information System)
(1996). The Norwegian Social and Health Department,
Oslo.
Kalnins, I., McQueen, D. V., Backett, K. C., Curtice, C. and
Currie, C. E. (1992) Children, empowerment and health
promotion: some new directions in research and practise.
Health Promotion International, 7, 53–59.
King, A. C., Jeffery, R. W., Fridinger, F., Dusenbury, L.,
Provence, S., Hedlund, S. A. et al. (1999) Environmental
and policy approaches to cardiovascular disease
prevention through physical activity. Health Education
Research, 22, 499–511.
Levin, S., Ainsworth, B. E., Kwok, C. W., Addy, C. L. and
Popkin, B. M. (1999) Patterns of physical activity among
Russian youth. European Journal of Public Health, 9,
166–173.
Lindquist, C. H., Reynolds, K. D. and Goran, M. I. (1999)
Sociocultural determinants of physical activity among
children. Preventive Medicine, 29, 305–312.
Linenger, J. M., Chessonn, C. V. and Nice, D. S. (1991)
Physical fitness gains following simple environmental
change. American Journal of Preventive Medicine, 7,
298–310.
Lumsdon, L. and Mitchell, J. (1999) Walking, transport and
health: do we have the right prescription? Health
Promotion International, 14, 271–279.
Morris, J. N. and Hardman, A. E. (1997) Walking to health.
Review. Sports Medicine, 23, 306–332.
Myers, L., Strikmiller, P. K., Webber, L. S. and Berenson,
G. S. (1996) Physical and sedentary activities in school
children grades 5–8. Medicine and Science in Sports and
Exercise, 28, 852–859.
National Bureau of Statistics (1984) Standard classification
of socio-economic status. Norwegian text. Oslo.
Oia, T. (1994) Norske ungdomskulturer. (Norwegian Youth
cultures.) Opplandske Bokforlag, Norway.
Pate, R., Pratt, M., Blair, S., Haskell, W. L., Macera, C. A.,
Bouchard, C. et al. (1995) Physical activity and public
health. A recommendation from the Centers for Disease
Control and Prevention and the American College
[Review.] Journal of the American Medical Association,
273, 402–407.
Rütten, A., Abel, T., Kannas, L., von Lengerke, T., Luschen,
G., Rodrigues Diaz, J. A. et al. (2001) Self reported
physical activity, public health and perceived
environment: results from a comparative European
study. Journal of Epidemiology and Community Health,
55, 139–145.
Sallis, J. F., Zakarian, J. M., Hovell, M. F. and Hofstetter,
C. R. (1996) Ethnic, socioeconomic, and sex differences
in physical activity among adolescents. Journal of Clinical
Epidemiology, 49, 125–134.
Schmidt, T. L., Pratt, M. and Howze, E. (1995) Policy as
intervention: environmental and policy approaches to the
prevention of cardiovascular disease. American Journal
of Public Health, 85, 1207–1211.
Simons-Morton, B. G., McKenzie, T. J., Stone, E., Mitchell,
P., Osganian, V., Strikmiller, P. K. et al. (1997) Physical
activity in a multiethnic population of third graders in
four states. American Journal of Public Health, 1, 45–50.
Sjolie, A. N. (2000) Pedestrian roads access, daily activities
and physical performance in adolescents. SPINE, 25,
1965–1972.
Solstad, K. J. (1973) Skoleskyss og fysisk helse. (School bus
and physical health.) Dissertation. Norwegian text,
English summary. University of Tromso, Norway.
Sothern, S., Loftin, M., Suskind, R. M., Udall, J. M. and
Blecker, U. (1999) The health benefits of physical activity
in children and adolescents: implications for chronic disease prevention. [Review.] European Journal of
Pediatrics, 158, 271–274.
Strauss, R. (1999) Childhood obesity. [Review.] Current
Problems in Pediatrics, 29, 1–29.
Stronks, K., van de Mheen, H., Looman, C. W. N. and
Mackenbach, J. P. (1996) Behavioural and structural
factors in the explanation of socio-economic inequalities
in health: an empirical analysis. Sociology of Health and
Illness, 18, 653–674.
US Surgeon General (1996) Physical activity and health.
A report from the Surgeon General. National Center for
Chronic disease Prevention and Health Promotion,
Atlanta, US.
Vibe, N. (1993) Våre daglige reiser. Endringer i nordmenns
reisevaner fra 1985 til 1992. [Our daily travels.
Alterations in the travel habits of the Norwegians from
1982 to 1992.] Report 171, Transportøkonomisk Institutt,
Oslo.
WHO (1996) Ottawa Charter for Health Promotion. An International Conference on Health Promotion. WHO, Geneva.
Activities in adolescents
29
APPENDIX: QUESTIONNAIRE OF DAILY LIFE ACTIVITIES
1. How long is your school journey one way? (km)
2. How long does the journey take from home to school? (min)
3. How do you usually travel to school?
(i) Walking
(ii) Cycling
(iii) School bus
(iv) Private car
4. For those using a school bus:
4.1. What is the distance from home to the bus stop? (km)
4.2. How do you usually get from home to the bus stop?
(i) Walking
(ii) Cycling
(iii) Private car
4.3. How long does the bus journey take one way to school? (min)
5. How many hours do you usually spend weekly on television and computer, video and computer
games included?
6. How many hours do you usually spend reading, lessons included?
7. How many times weekly do you usually engage in planned leisure physical activity, including cycling
and tracking (at least 45 min duration)?
(i) None
(ii) 1–2
(iii) 3–4
(iv) 5 or more
8. How many times weekly do you usually engage in planned non-physical activity (at least 45 min
duration)?
(i) None
(ii) 1–2
(iii) 3–4
(iv) 5 or more
9. Activities and journeys: include activities performed for at least the last 2 months and previous
activities, stopped within the last 2 months, performed for at least 6 months.
Activity type
Times
weekly
Time use
weekly
(h)
Distance
home to
activity
(km)
Usual
way of
transport
Drive Walk/cycle Both
Football
Handball
Aerobics/gymnastics
Skiing/slalom
Skating
Swimming
Jogging
Forest tracking
Horse riding
Other physical activity:
describe ……………………
Handwork, carpentry
Scouting
Active music
Other non-physical activity:
describe …………………..
Time spent
Sport
in transport competition
one way
(min)
Yes
No
30
A. N. Sjolie and F. Thuen
10. How often do you perform physical work like snow shovelling, washing floors, heavy farm work (at
least 45 min duration)?
(i) Daily
(ii) Weekly
(iii) Monthly
(iv) Some times a year
(v) Never
11. How often do you participate in driving a tractor or a scooter (at least 45 min duration)?
(i) Daily
(ii) Weekly
(iii) Monthly
(iv) Some times a year
(v) Never