BACKGROUND: The family has been acknowledged as central to developing physical activity (PA) beliefs and behaviours. However, increased diversity in family structures has developed over the last decades. This study examines the association between family structure and PA among adolescents and cross-national variations in the associations. METHODS: The data are from the 2013/14 Health Behaviours in School-Aged Children study, involving nationally representative samples of 11-, 13- and 15-year-olds (n = 211,798) from 40 countries. Multilevel Poisson regression analysis was used to examine the associations between family structure and moderate to vigorous physical activity (MVPA) and vigorous physical activity (VPA) by age, gender, socioeconomic status (SES), and geographic region. RESULTS: Living with one versus two parents was associated with a reduced likelihood of daily 60 min MVPA for boys (IRR = 0.96, 95% CI: 0.92, 0.99) and ≥ 4 times/week VPA (IRR 0.93, 95% CI: 0.91, 0.95). This impact on MVPA differed across individual-level SES (high SES; IRR = 0.92, (p <0.05), low SES; IRR = 1.04, (ns)), and was for VPA only significant for those with siblings (IRR = 0.93, 95% CI: 0.91, 0.96). Cross-country variations in the association between living with one versus two parents were observed, most pronounced for VPA. These differences varied by region, primarily explained by country-level SES differences between regions. The likelihood of daily 60 min MVPA also increased with siblings in the main house (IRR 1.11, 95% CI: 1.07, 1.14), and ≥ 4 times/week VPA decreased with grandparents in the main house (IRR 0.91, 95% CI: 0.89,0.94). CONCLUSIONS: Family structure correlated with PA, but cross-country differences exist. The findings are relevant for the development of policies and programs to facilitate PA, especially in countries where living with one versus two parents was unfavourable. Additional country-specific research is needed to identify challenges for engaging in PA related to family structure.

CIPER Faculdade de Motricidade Humana Universidade de Lisboa Lisbon Portugal

Department of Clinical and Biological Sciences Public Health and Paediatrics University of Torino Orbassano Italy

Department of Health Promotion and Development University of Bergen Bergen Norway

Department of Health Promotion Norwegian Institute of Public Health Bergen Norway

Department of Health Psychology and Research Methodology Faculty of Medicine P J Safarik University in Kosice Kosice Slovakia

Department of Teacher Education NLA University College Bergen Norway

Faculty of Education University of Turku Turku Finland

Faculty of Health and Social Sciences Western Norway University of Applied Sciences Inndalsveien Bergen Norway

Faculty of Sport and Health Sciences University of Jyvaskyla Jyvaskyla Finland

ISAMB Universidade de Lisboa Lisbon Portugal

National Institute for Health Development Estonia

Olomouc University Social Health Institute Palacky University Olomouc Olomouc Czech Republic

Physical Activity for Health Research Centre Department of Physical Education and Sport Sciences Health Research Institute University of Limerick Limerick Ireland

School of Educational Sciences and Psychology University of Eastern Finland Finland

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