Association Between Participation in Physical Education Classes and Physical Activity Among 284,820 Adolescents: A Progressive Exposure Gradient Analysis

Purpose : The purpose of this study is to analyze the associations between participation in physical education (PE) classes and days with ≥60 minutes of moderate- to vigorous-intensity physical activity (MVPA) using different reference categories for participation in PE. Methods : We used self-reported data from 284,820 adolescents. Results : When no participation in PE was the reference, participation on 1 (prevalence ratio [PR] = 1.15 [1.12–1.18]), 2 (PR = 1.24 [1.20–1.27]), 3 to 4 (PR = 1.32 [1.28–1.36]), and ≥5 days per week (PR = 1.8 [1.33–1.43]) increased frequency of days of ≥60 minutes of MVPA. Participating in PE on 2 (PR = 1.07 [1.02–1.09]), 3 to 4 (PR = 1.15 [1.12–1.18]), and ≥5 days per week (PR = 1.18 [1.15–1.22]) increased the days of ≥60 minutes of MVPA when participation in PE classes on 1 days per week was the reference. When participation in PE on 2 days per week was the reference, participation in PE classes on 3 to 4 (PR = 1.07 [1.04–1.09]) and ≥5 days per week (PR = 1.12 [1.09–1.15]) increased the days of ≥60 minutes of MVPA. Participating in PE classes on ≥5 days per week increased the days of ≥60 minutes of MVPA (PR = 1.05 [1.03–1.07]) when participation on 3 to 4 days per week was the reference. Conclusions : For those with no participation in PE classes, the addition of any PE classes could positively impact the weekly frequency of days of ≥60 minutes of MVPA. Even in countries/territories with large coverage of participation in PE classes, promoting more PE classes could be useful to increase physical activity.