Physical activity, screen time, and school absenteeism: Self-reports from NHANES 2005-2008

Objective The purpose of this study was to examine how lifestyle behaviors in the context of physical activity levels and screen time are associated with school absenteeism.Methods We analyzed 2005-2008 NHANES data of proxy interviews for 1048 children aged 6-11 years and in-person self-reports of 1117 adolescents aged 12-18 years. Missing 10% of school days during the past school year was defined as severe school absenteeism (SSA).Results Watching TV ≥2 hours a day was significantly associated with SSA among both children (OR = 3.51 [1.03-12.0]) and adolescents (OR = 3.96 [1.84-8.52]) compared with their peers watching <2 hours a day. A U-shaped association was identified between the level of physical activity and SSA among children. Both inactive children (OR = 12.4 [1.43-108]) and highly active children (14.8 [2.82-77.7]) had higher odds of SSA compared with children with medium levels of physical activity. No associations were observed for either children 0.57 ([0.16-1.99]) or adolescents (0.94 [0.44-2.03]) using a computer ≥3 hours a day.Limitations Cross-sectional study involving self-reports. Transportation to and from school not included in physical activity assessment. Absenteeism was not validated with report cards. Unable to account for the absence type or frequency of illness or injury. No psychometric properties provided for subjective measures regarding participants attitudes and characteristic traits towards physical activity, TV viewing, and school attendance.Conclusions Excessive TV watching among children and adolescents, and inactivity and high activity levels (≥7 times per week) among children are independently associated with severe school absenteeism.