@Article{IJMHP.2021.016274,
AUTHOR = {Shuan Liu, Sitong Chen, Xiaohong Zhu, Brendon Stubbs, Qian Yu, Mark D. Griffiths, Can Jiao, Aiguo Chen, Md Mahbub Hossain, Zsolt Demetrovics, Albert S. Yeung, Jinming Li, Xingyu Zhang, Liye Zou},
TITLE = {Association between Active School Travel and Depressive Symptoms among 51,702 Adolescents in 26 Low- and Middle-Income Countries},
JOURNAL = {International Journal of Mental Health Promotion},
VOLUME = {23},
YEAR = {2021},
NUMBER = {2},
PAGES = {141--153},
URL = {http://www.techscience.com/IJMHP/v23n2/42586},
ISSN = {2049-8543},
ABSTRACT = {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>I</i><sup>2</sup> = 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 factors when implementing AST-related mental health interventions. Future studies should adopt the solid study
design to confirm or negate our research findings.},
DOI = {10.32604/IJMHP.2021.016274}
}