The aim was to assess the association between physical activity and screen-based activities in adolescents and selected school factors and urbanization and whether these associations were modified by degree of urbanization.
We obtained data regarding the fifth-ninth grade students from 130 schools in 2014 via the Health Behaviour in School-aged Children cross-sectional study in Slovakia (n = 9743, mean age = 13.5, 50.3% boys). We explored the associations using multilevel logistic regression.
We found significant associations between physical activity and the accessibility of an area for skating/tennis court [odds ratio (OR) = 1.20 and 95% confidence interval (CI) 1.01-1.42], and between physical activity and active breaks (OR = 0.83 and 95% CI 0.69-0.99). The rates of screen-based activities were higher in small towns (OR = 1.63, 95% CI 1.29-2.06), towns (OR = 1.30, 95% CI 1.08-1.57), and cities (OR = 1.40, 95% CI 1.04-1.87) than in villages.
School environment and degree of urbanization are associated with adolescents' physical activity and screen-based activities. This holds positively for access to an area for skating/tennis court and negatively for active breaks regarding physical activity and for living in villages regarding less use of screens.