| Abstract: | Little is known about the role of active school travel (AST) on mental health among adolescents. Thus, this studyaimed 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 in51,702 adolescents [mean (SD) age 13.8 (1.0) years; 49.3% boys). Both depressive symptoms and AST wereassessed by a single question self-reported measure, respectively. Participants who reported having 5 days orabove 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, anda 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 tohave self-reported depressive symptoms (OR = 0.88, 95%CI: 0.85-0.93) regardless of gender. Countrywidemeta-analysis demonstrated that having AST versus not having AST was associated with 12% lower odds fordepressive symptoms (OR = 0.88; 95%CI: 0.82-0.94) but with a moderate between-country heterogeneity(I2 = 59.0%). Based on large samples of adolescents from LMICs, it would be expected that AST may play a criticalrole 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 studydesign to confirm or negate our research findings. |
