Parental and Peer Support are Associated with Physical Activity in Adolescents: Evidence from 74 Countries.

Although parental and peer support can influence adolescents' physical activity (PA), these associations have not been fully examined through a global assessment. This study examined the associations of parental and peer support with PA among adolescents from 74 countries. The Global School-based Student Health Survey data from 250,317 adolescents aged 11-17 years (48.8% girls), collected between 2007 and 2016, were analysed. Adolescents were asked how many days/week they were physically active and about their parental and peer support. Meta-analysis showed that adolescents who had high parental or peer support had higher odds of attaining sufficient PA (odds ratio (OR): 1.40, 95% confidence interval (CI): 1.34-1.46; OR: 1.57, 95% CI: 1.49-1.65, respectively). Pooled estimates of association were significant across all World Health Organization (WHO) regions and country-income categories with the highest estimate from the low-income countries. The Western Pacific region showed the highest association between parental support and adolescents' PA (OR: 1.49, 95% CI: 1.41-1.59), while South-East Asia exhibited the highest association between peer support and adolescents' PA (OR: 1.80, 95% CI: 1.59-2.04). Country-level estimates of associations are presented. Future studies should use robust assessment of PA and PA-specific parental and peer support with emphasis on qualitative investigation to understand the complexity of the relationships.