The association between overweight and opportunity structures in the built environment: a multi-level analysis among elementary school youth in the PLAY-ON study
To examine school-level opportunity structures of the built environment and student characteristics associated with being overweight.Multi-level logistic regression analysis were used to examine the school- and student-level characteristics associated with the odds of a student being overweight among grade 5-8 students attending 30 elementary schools in Ontario, Canada, as part of the Play-Ontario (PLAY-ON) study.Significant between school random variation in overweight was identified [σ²(μ0)= 0.187 (0.084), P < 0.001]; school-level differences accounted for 5.4% of the variability in the odds of a student being overweight. The more fast-food retailers there were surrounding a school, the more likely a student was to be overweight; students in grade 5 were at increased risk relative to students in grades 6-8. The more grocery stores there were surrounding a school, the more likely a student was to be overweight; students in grade 5 were at increased risk relative to students in grades 6-8.Developing a better understanding of the school- and student-level characteristics associated with overweight among youth is critical for informing intervention programs and policies.