EVALUATION OF THE THEORY OF PLANNED BEHAVIOR TO DETERMINE PHYSICAL ACTIVITY IN SAUDI FEMALE ADOLESCENTS

Abstract

Background and Significance: The significant increase in obesity rates among Saudi female adolescents is a major public health concern. The main factor linked to the high prevalence of obesity among Saudi female adolescents is that only 12.9% attain the World Health Organization (WHO) recommendation calling for 60 minutes/day of moderate to vigorous physical activity (MVPA). The low level of physical activity (PA) among Saudi female adolescents could be attributed to several psychosocial factors that stem from the culture and environment of Saudi Arabia. Understanding these factors is essential to effectively address the low PA problem and plan an intervention. Framework: The conceptual framework for this study was the Theory of Planned Behavior (TPB). Purpose: The primary purpose of the cross-sectional study was to examine the relationship between self-reported PA and TPB psychosocial factors, including attitude toward PA, subjective norms, perceived behavioral control (PBC), and PA intention among Saudi female adolescents in the Eastern Region, Saudi Arabia. Sample: A convenience sample of 329 Saudi female adolescents’ (aged 13–18 years) was recruited from intermediate and high schools in the Eastern Region, Saudi Arabia. Methods: Adolescents from all-female public schools in the Eastern Region of Saudi Arabia were recruited. Administrators in each school sent a link to parents of the students to request parents’ consent for their daughters to participate. Eligible adolescents were asked to complete an online TPB questionnaire and Physical Activity Questionnaire for Adolescents (PAQ-A) via Qualtrics. SPSS was used to calculate descriptive statistics. Mplus was used to conduct Structural Equation Modeling (SEM). Results: The mean age of participants in the study was 15.7 years. Among participants, 14.2% were overweight and 7.3% were obese. Mean PA score was 1.8 (SD = 0.74), indicating low PA level. The structural model exhibited an acceptable fit to the data [x2(217) = 412.28, p < 0.001, RMSEA = .05 with 90% CI [.04-.06], CFI = .93, TLI = 0.92 SRMR= .0.05]. The model explained (53%) and (21%) of the variance in PA intention and PA, respectively. The strongest predictor of adolescents’ intention was attitude (B=0.43, p<.001) followed by PBC (B=0.36, p<.001). Moreover, the female adolescents’ attitude (B=0.17, p<0.01), and PBC (B=0.14, p<0.01) had significant indirect effects on self-reported PA through intention. Additionally, intention (B=0.40, p<0.001) had a direct effect on PA. The model did not support the indirect relationship of SN. However, the study found that SN moderated the intention-PA. The interaction effect was statistically significant (B=0.47, p<.01, 95% CI=0.15-0.78). Moreover, only father education had a significant negative relationship with PBC (B=-0.13, p<.05). Conclusions: The results suggest that attitude, PBC and PA intention are psychosocial factors that collectively tie with PA among Saudi female adolescents. The nuanced understanding derived from TPB-based modeling here can help in developing effective interventions to promote PA in these at-risk female adolescents. Implications: The findings demonstrate the significant contributions of TPB’s psychosocial factors in predicting PA intention and PA among Saudi female adolescents. These results provide needed information for nurses, health professionals, and researchers to develop and test a theory-based intervention to promote PA and reduce obesity-related diseases for Saudi female adolescents. Moreover, nurses can advocate for school policies targeted toward improving PA in order to prevent and decrease childhood obesity.