Bullying victimization, physical inactivity and sedentary behavior among children and adolescents: a meta-analysis

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Bullying victimization, physical inactivity and sedentary behavior among children and adolescents: a meta-analysis Antonio García-Hermoso1,2* , Ignacio Hormazabal-Aguayo2, Xavier Oriol-Granado3, Omar Fernández-Vergara2 and Borja del Pozo Cruz4

Abstract Background: Physical activity and sedentary behavior are related with psycho-social variables among youth, however its relationship with bullying victimization is unclear. The aim of the study was to clarify the associations between physical activity and sedentary behaviors with bullying victimization among children and adolescents. Methods: Two independent authors searched in four databases. The studies were selected/included only if participants were children and/or adolescents and the relationship between physical activity and/or sedentary behavior with bullying victimization was reported. Random-effects meta-analyses were used. Results: A total of 18 cross-sectional studies (including 386,740 children and adolescents, 51.8% females) were reviewed. Our study found that not meeting the physical activity guidelines (Odds Ratio [OR] = 1.14, 95% confidence interval [CI], 1.04 to 1.23) and excessive sedentary behavior (i.e., 2 h per day or more of screen time) (OR = 1.21, 95% CI, 1.14 to 1.28) were associated with 14 and 21% higher bullying victimization, respectively. Consistent associations were also found when we analyzed specific forms of bullying for sedentary behavior, including traditional and cyberbullying. Conclusions: The present study establishes the first quantitative framework for understanding the influence of physical activity and sedentary behavior on bullying victimization, and lays the groundwork for future studies and interventions aimed to its promotion. Trial registration: CRD42018099388. Keywords: Physical exercise, Sitting time, Screen time, traditional bullying, Cyberbullying

Introduction Bullying victimization denotes to the process by which an individual is repeatedly and over time exposed to intentional harmful or negative actions by their counterparts [1]. Bullying can occur in different environments, * Correspondence: [email protected] 1 Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IdiSNA, Calle de Irunlarrea, 3, Postal Code: 31008 Pamplona, Navarra, Spain 2 Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago, Chile Full list of author information is available at the end of the article

including but not limited to workplace, community settings, schools and home [2]. Bullying victimization is prevalent across countries worldwide, reaching prevalence rates up to 35% for traditional bullying and 15% for cyberbullying [3]. According to the Centers for Disease Control and Prevention (CDC), bullied youths frequently report high levels of poor school performance, sleep difficulties, loneliness, anxiety, depression [4] and are more likely to commit suicide [5]. Physical inactivity among youth predicts