Physical inactivity and its predictors among adolescents in Saudi Arabia: A cross-sectional comparison between cities with and without a Healthy Cities Program

Objectives:To estimate the prevalence of insufficient physical activity and excessive screen time among adolescents living in cities participating in the Healthy Cities Program (HCP) and cities not running the program in the Qassim region of Saudi Arabia.Methods:We surveyed 1133 adolescents from the Qassim region using systematic random sampling between April and September 2017. Multivariable logistic regression analyses were conducted to investigate the predictors of insufficient levels of PA and excessive screen time.Results:The prevalence of <60 minutes of moderate- to vigorous-intensity physical activity/day was 82.4% and <3 days of vigorous intensity physical activity/week among adolescents was 59%. There was no significant association between living in healthy cities (HCPs) and insufficient levels of physical activity. The odds of excessive screen time were higher in HCPs than in cities not running the program (NHCPs) (OR: 1.49). The odds of insufficient daily PA (OR: 2.19) are higher among girls than boys. Increasing age is positively associated with insufficient weekly PA (OR: 1.19). The prevalence of excessive recreational screen time is 84.6% with higher odds in HCPs than in NHCPs (OR: 1.51).Conclusion:Our findings report a lack of evidence of any impact of the HCP on adolescents’ physical activity behaviors. This outcome warrants a further in-depth evaluation of the process and outcomes of the HCP in Saudi Arabia.