Participation in physical education classes and social isolation among adolescents: A harmonized analysis with 266,156 participants from 69 countries

Objective: To analyze the association between participation in physical education (PE) classes and social isolation among adolescents. Methods: We used data from the Global School-based Health Survey, comprising 266,156 adolescents from 69 countries/territories. Participation in PE classes (days/week) was reported by the students. Social isolation was assessed through questions regarding the number of friends and loneliness perception. Poisson regression models were used to identify the association of weekly participation in PE classes with social isolation, and harmonized meta-analyses were used to estimate a summary association. Results were expressed through prevalence ratios (PR) and their respective confidence intervals (95%CI). Results: Adolescents who participated in PE classes on one [PR:0.87 (95%CI:0.83; 0.92)], two [0.84 (0.79; 0.89)], and three or more days per week [0.77 (0.73; 0.82)] had a lower prevalence of having a low number of friends than their peers with no PE classes. The loneliness perception was lower among those who participated in PE classes on one [0.86 (0.81; 0.90)], two [ 0.93 (0.87; 0.98)], and three or more days per week [0.94 (0.90; 0.98)] than among those who did not participate in PE classes. Participation in PE classes was also associated with lower social isolation (combined indicator: a low number of friends + loneliness perception) [1 PE day/wk: 0.88 (0.85; 0.92); 2PE days/wk: 0.88 (0.84; 0.92); ≥3 PE days/wk: 0.85 (0.82; 0.89)]. Conclusions: Participating in at least one PE class per week is associated with a lower perception of social isolation among adolescents. Countries should seek to promote student participation in PE classes as a way of reducing social isolation.