Professional Documents
Culture Documents
Published online ahead of print May 16, 2013 | American Journal of Public Health
METHODS
We conducted a systematic
search of peer-reviewed journals
in May 2012 in the PubMed,
Sociological Abstracts, EconLit,
and Web of Science databases.
Because patterns of physical activity have changed over time, we
focused on studies published since
2000 to identify the most relevant
information for todays youths.
Searches used combinations of
keywords that included a friendship term (friend* or peer*)
and a physical activity term
(sport* or physical activity or
exercise). We included the word
peer in searches because it is
sometimes used to mean friend,
but only retained the articles
where peer referred explicitly to
friends rather than to general peer
groups or schoolmates. We did not
include schoolmates and peer
groups not specically identied
as friends because our goal was to
quantify the importance of friends,
who are more inuential than
other social contacts, according to
the literature.23---26
Study Selection
We included articles if they (1)
were published in English, (2)
were published in or after 2000,
(3) presented results from analyses
SYSTEMATIC REVIEW
Identification
RESULTS
Eighty-one quantitative articles
met inclusion criteria. Of these
studies, 40 reported signicant
positive associations between a
measure of friendship inuences
and respondents physical activity
in all populations and models,45---84
30 reported signicant positive
associations in some but not all
populations or models,26,85---113
and 11 reported no signicant
positive associations.114---124
Screening
Eligibility
Abstracts screened
(n = 3939)
Studies included in
qualitative synthesis
(n = 25)
Included
Studies included in
quantitative synthesis
(n = 81)
Records excluded
(n = 3668)
FIGURE 1Literature search for research on influence of friends on childrens physical activity, 2000
2012.
American Journal of Public Health | Published online ahead of print May 16, 2013
Published online ahead of print May 16, 2013 | American Journal of Public Health
47
Ievers-Landis et al.53
Leslie et al.94
Ommundsen et al.55
Ommundsen et al.55
Ommundsen et al.55
Jago et al.91
Jago et al.91
Zhang et al.78
Duncan et al.87
Wenthe et al.107
Wu et al.72
Taymoori et al.122
at school
WBPA
Overall PA
Overall PA
Overall PA
Overall PA
Overall PA
Overall PA
Overall PA
Overall PA
Kirby et al.109
Overall PA
Overall PA
Overall PA
Overall PA
MVPA
MVPA
MVPA
MVPA
MVPA
MVPA
MVPA
MVPA
MPA
MVPA
VPA
VPA
VPA
VPA
PA Indicator (Outcome)
Loucaides58
Duncan et al.49
Wenthe et al.
Patnode et al.106
107
Kelly et al.92
Kitzman-Ulrich et al.119
Huang et al.52
Hsu et al.118
Heitzler et al.51
Anderson et al.
Bergh et al.46
115
Sallis et al.
103
Sallis et al.
103
Kelly et al.92
Anderson et al.114
Study
X
X
X
X
Friend
Indicator
PA Objectively Objectively Longitudinal
Measured
Measured
Design
657
657
760
760
2961
760
354
285
371
205
832
558
193
878
6078
641
652
119
371
202
205
294
1180
669
423
303
666
63
408
1129
200
781
1180
408
Sample
Size
1011 y
1011 y
915 y
915 y
1014 y
915 y
811 y
1215 y
1217 y
1214 y
1215 y
1217 y
Grade 6
1115 y
1119 y
1115 y
Grades 79
1415 y
1217 y
Grades 68
1214 y
1017 y
Grade 6
Grade 6
1216 y
914 y
Middle school
1017 y
1315 y
11 y
Grades 112
Grades 112
Grade 6
1315 y
US
US
US
China
US
US
Belgium
Scotland
Cyprus
Australia
US
US
US
US
US
US
US
Taiwan
Both
Both
Both
Both
Both
Both
UK
UK
Norway
Norway
Australia
Norway
Female US
Both
Both
Both
Both
Female Iran
Female Estonia
Both
US
Both
Both
Both
Both
Both
Both
Both
Both
Location
US
Norway
US
US
Female US
Both
Both
Both
Both
Both
Both
Both
Both
Both
Female US
Both
Age Group,
Range or Mean Gender
X
X
X
X
Continued
Xd
Xg,d
X
Xd
X
Xf
Xe
Xd
Xd
Xb
Xc
Xc
Xb
Findings
Consistent
Covariates With Influence
SYSTEMATIC REVIEW
Overall PA
After school PA
Lunchtime PA
Active commute to school
Sports team participation
Change in PA
Dunton et al.124
Prochaska et al.102
Prochaska et al.102
Ha et al.79
Wu and Pender82
Hohepa et al.110
Hohepa et al.110
Hohepa et al.110
Johnson et al.54
Overall PA
VPA
MVPA
Sport team participation
Seabra et al.68
Seabra et al.76
Seabra et al.76
Wilson and Dollman108
Sharma et al.69
Sharma et al.70
Friend influences PA
Friend influences PA
Best friend encourages PA
Friend encourages PA
Friend encourages PA
participation
Jago et al.91
Overall PA
Change in MVPA
for PA
Jago et al.91
Overall PA
Lytle et al.111
Dunton et al.124
for PA
Overall PA
Lytle et al.111
Lytle et al.111
Bouts of MVPA
Lytle et al.111
Wenthe et al.107
Anderson et al.115
TABLE 1Continued
718
718
113
180
113
180
113
3352
180
3352
3352
857
857
857
657
657
193
145
3471
3471
3471
832
1538
138
138
63
3378
63
3378
3378
3378
205
1139
Grade 6
Grade 6
Grades 89
Grades 69
Grades 89
Grades 69
Grades 89
1018 y
Grades 69
1018 y
1018 y
1518 y
1518 y
1518 y
1011 y
1011 y
Grade 6
Grades 912
1218 y
1218 y
1218 y
1215 y
1116 y
Grades 68
Grades 68
Grades 1011
Grade 11
Grades 1011
Grade 10
Grade 9
Grade 8
1214 y
815 y
US
US
US
New Zealand
New Zealand
New Zealand
Taiwan
Australia
Hong Kong,
US
US
Australia
Australia
Australia
Australia
Australia
Portugal
Australia
Portugal
Portugal
Canada
Canada
Canada
UK
UK
Female US
Female US
Male
Male
Male
Male
Male
Both
Male
Both
Both
Both
Both
Both
Both
Both
Female Estonia
Both
Both
Both
Both
Both
Both
Both
Both
Female US
Female US
Female US
Female US
Female US
Female US
Both
Both
X
X
X
X
X
X
X
Continued
Xh
Xh
X
X
SYSTEMATIC REVIEW
American Journal of Public Health | Published online ahead of print May 16, 2013
MVPA
MVPA
VPA
60 min MVPA 7 d/wk
Overall PA
Overall PA
Frequency of changing exercise
Springer et al.71
Anderson et al.115
Springer et al.71
Lemstra et al.113
Prochaska et al.102
Prochaska et al.102
Martn-Matillas et al.96
Martn-Matillas et al.96
Martn-Matillas et al.96
Friend encourages PA
Friend encourages PA
Friend encourages PA
Friend encourages PA/sports
Published online ahead of print May 16, 2013 | American Journal of Public Health
Lemstra et al.113
Overall PA
Bike to school
Walk to school
WBPA
Overall PA
Overall PA
MVPA
Coppinger et al.86
Panter et al.100
Panter et al.100
Price et al.101
Prochaska et al.102
Prochaska et al.102
Friends criticize PA
Overall PA
MVPA
Overall PA
Macdonald-Wallis et al.60
Martn-Matillas et al.95
Martn-Matillas et al.95
Friends do PA now
Overall PA
Macdonald-Wallis et al.60
Friends modeling of PA
biking to school
PA (perceived)
Change in MVPA
de la Haye et al.88
Overall PA
Finnerty et al.50
Lemstra et al.113
Kahn et al.97
Overall PA
Coppinger et al.86
2260
559
2260
559
197
138
138
1000
2012
2012
106
378
4197
12 812
4197
315
106
106
669
3007
3007
MVPA
Overall PA
MVPA
3007
362
138
138
718
4197
3007
Overall PA
Kitzman-Ulrich et al.119
Friend discourages PA
718
1139
VPA
Martn-Matillas et al.96
718
718
MPA
to decrease weight
Sharma et al.70
Friend encourages PA
behavior
Sharma et al.69
Friend encourages PA
TABLE 1Continued
1318.5 y
1011 y
1318.5 y
1011 y
Grades 78
Grades 68
Grades 68
912 y
910 y
910 y
911 y
1215 y
915 y
1018 y
915 y
1013 y
911 y
911 y
Grade 6
12.517.5 y
12.517.5 y
12.517.5 y
12.517.5 y
1214 y
Grades 68
Grades 68
1014 y
915 y
815 y
1014 y
Grade 6
Grade 6
US
UK
UK
UK
Australia
Canada
US
Canada
UK
UK
UK
US
Europe
Europe
Europe
Europe
Australia
US
US
Both
Both
Both
Both
Both
Both
Both
Spain
UK
Spain
UK
Estonia
US
US
Female US
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Male
Both
Both
Female US
Both
Canada
Both
Female US
Female US
Female US
X
X
X
X
X
X
X
X
Continued
Xh
Xj
X
X
Xi
X
X
SYSTEMATIC REVIEW
Martn-Matillas et al.96
Martn-Matillas et al.96
Loucaides et al.112
Martn-Matillas et al.96
Best friends PA
Best friends PA
Participation in organized PA
Participation in non-organized PA
de la Haye et al.75
de la Haye et al.75
Friends PA
Friends PA
Duncan et al.87
Friends PA
VPA
MPA
MVPA
MVPA
WBPA
Jumping activities, d/wk
King et al.56
King et al.56
Springer et al.71
Springer et al.71
Price et al.101
Sharma et al.70
Gilmer et al.116
Friends PA
Friends PA
Friends PA
Friends PA
Friends PA
Friends PA
or hard PA
Jago et al.
Duncan et al.87
Leatherdale et al.
Leatherdale et al.57
Schofield et al.26
Friends overall PA
90
Change in friends PA
Friends MVPA
57
VPA
McDermott et al.61
Friends PA
Jago et al.90
Plotnikoff et al.77
Friends PA
Overall PA
Moderately active
Highly active
Change in PA
Overall PA in CPM
MVPA min/d
Overall PA
Overall PA
Bramoulle et al.83
Friends PA
Overall PA
Luszczynska et al.81
Overall PA
Overall PA
Overall PA
Overall PA
Friends PA
Sharma et al.
Voorhees et al.105
Friends PA
70
Schofield et al.
Friends PA
Friends PA
Duncan et al.87
Gesell et al.74
Friends PA
Friends PA
26
Change in PA
Change in percentage of after
de la Haye et al.75
Friends PA
Change in MVPA
de la Haye et al.
Friends PA
Change in MVPA
past 7 d
Plays active sports
Ali et al.45
Friends PA
75
Xk
Xk
X
X
318
2379
2379
371
472
472
113
1000
718
718
718
535
535
1407
2688
Both
Canada
US
US
US
Australia
Australia
Australia
Australia
US
Europe
US
Cyprus
Europe
Europe
Europe
Female US
Female Australia
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
1320 y
1518 y
Grades 58
Grades 58
1217 y
1011 y
1011 y
1114 y
912 y
Grade 6
1014 y
1014 y
Grades 912
Grades 912
913 y
Grades 912
US
US
US
Canada
Turkey, US
US
Hungary, Poland,
Canada
Canada
US
UK
UK
US
Female Australia
Both
Both
Both
Both
Both
Both
Female US
Female US
Female US
Female US
Both
Both
Both
Both
Both
Both
Grade 6
1518 y
1217 y
1217 y
512 y
1215 y
1215 y
Grades 89
Grades 89
1218 y
12.517.5 y
1218 y
Grade 6
12.517.5 y
12.517.5 y
12.517.5 y
15.62 y
2387
488
718
318
371
371
81
378
378
385
385
3898
Overall PA
Exercised 3 times in
Ali et al.45
256
3007
3898
MVPA
3007
3007
MVPA
3007
MPA
VPA
2688
MVPA
Best friends PA
Friends PA
Best friends PA
Best friends PA
Loucaides et al.59
Martn-Matillas et al.96
TABLE 1Continued
X
X
X
X
X
X
X
X
X
Continued
X
X
Xh
Xd,k
X
X
Xk
Xh
Xd
X
X
X
SYSTEMATIC REVIEW
American Journal of Public Health | Published online ahead of print May 16, 2013
Leisure-time sports
VPA
Does muscle-strengthening
Page et al.98
Keresztes et al.93
Page et al.99
Page et al.99
Page et al.99
active
All friends are physically
3 friends do sports
Published online ahead of print May 16, 2013 | American Journal of Public Health
Does muscle-strengthening
Participates in team sports
Is active outside school
Overall PA
MVPA
Overall PA
Page et al.98
Page et al.98
Page et al.98
Page et al.98
Ries et al.121
exercise
VPA
VPA
Page et al.98
VPA
MVPA
MVPA
active play
active play
active play
Best friend engages in
active play
active play
Overall PA
Page et al.99
active play
VPA
Page et al.
Page et al.99
exercise
Overall PA
active
active
99
Page et al.98
exercise
Participates in team sports
Page et al.98
active
Does muscle-strengthening
Page et al.98
TABLE 1Continued
857
327
1886
1886
1886
1886
1886
113
180
113
180
113
180
2519
2519
2519
2519
2519
2519
548
1886
1886
1886
1886
1518 y
Grades 912
16.5 y
16.5 y
16.5 y
16.5 y
16.5 y
Grades 89
Grades 69
Grades 89
Grades 69
Grades 89
Grades 69
Grades 712
Grades 712
Grades 712
Grades 712
Grades 712
Grades 712
1015 y
16.8 y
16.7 y
16.6 y
16.5 y
Both
Both
Both
Both
Both
Both
Both
Male
Male
Male
Male
Male
Male
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
X
Canada
X
Czech Republic
US
X
Hungary, Romania,
Czech Republic
Hungary, Romania,
Czech Republic
Hungary, Romania,
Xd
X
Czech Republic
X
Czech Republic
Hungary, Romania,
X
X
Hungary, Romania,
Australia
Australia
Australia
Australia
Australia
Australia
Thailand
Thailand
Thailand
Thailand
Thailand
Thailand
Hungary
Czech Republic
Czech Republic
Hungary, Romania,
Hungary, Romania,
Czech Republic
Hungary, Romania,
Czech Republic
Hungary, Romania,
Continued
Xj
Xj
Xj
Xj,d
Xg
Xg
Xg,d
Xg
SYSTEMATIC REVIEW
MVPA
VPA
Overall PA
Overall PA
Overall PA
MVPA
Moderately active
Active
Overall sport participation
Saxena et al.67
Voorhees et al.105
Voorhees et al.105
Voorhees et al.105
Ries et al.121
Leggett et al.73
Leggett et al.73
Invited friend to do PA
Friends invite to be active
Fermino et al.89
PA with friends
1518
Overall PA
Distance biked
Overall PA
Salvy et al.66
Coppinger et al.86
Overall PA
Overall PA
MVPA min/d
Overall PA in CPM
Finnerty et al.50
Coppinger et al.86
Jago et al.90
Jago et al.90
Jago et al.90
Jago et al.
On sports team/in PA
Overall PA in CPM
MVPA min/d
Fermino et al.89
PA with friends
90
Overall PA
Overall PA
Prochaska et al.102
Prochaska et al.102
to exercise/do PA together
PA intensity
Salvy et al.65
Lemstra et al.113
Friends invite to be
472
472
472
472
106
315
1518
138
138
106
88
20
4197
VPA
VPA
active together
180
113
MVPA
113
180
113
180
488
272
31 202
31 202
327
488
488
Voorhees et al.105
305
488
PA with friends
857
857
Lemstra et al.113
participation
together
with friend
VPA
TABLE 1Continued
1518 y
Both
Canada
Canada
Female US
Both
Both
Both
Both
Both
Both
US
Canada
Canada
Canada
Canada
1011 y
1011 y
1011 y
1011 y
911 y
1013 y
1418 y
Grades 68
Grades 68
911 y
1214 y
1214 y
915 y
Grades 69
Grades 89
Grades 89
Grades 69
Grades 89
Grades 69
1418 y
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Both
Male
Male
Male
Male
Male
Male
Both
UK
UK
UK
UK
UK
UK
Brazil
US
US
UK
US
US
Canada
Australia
Australia
Australia
Australia
Australia
Australia
Brazil
915 y
Grade 6
912 Grades
Grades 912
Grades 912
1221 y
1518 y
X
X
X
X
X
Continued
Xh,m
Xh,l
SYSTEMATIC REVIEW
American Journal of Public Health | Published online ahead of print May 16, 2013
SYSTEMATIC REVIEW
1011 y
1011 y
1011 y
131
131
131
Overall PA
do PA to be with friends
Jago et al.85
Neighborhood affiliation,
do PA to be with friends
with friends
Neighborhood affiliation,
Jago et al.85
MVPA
Light PA
do PA to be
Jago et al.85
to be with friends
Neighborhood affiliation,
Note. CPM = counts per minute; MPA = moderate-intensity PA; MVPA = moderate-to-vigorous PA; PA = physical activity; VPA = vigorous-intensity PA; WBPA = weight-bearing PA.
a
Sallis et al. Social support scale.125
b
For Blacks and Whites but not Hispanics.
c
Only in some grades for girls and for boys.
d
Boys only.
e
Only medium level of support, compared with low support.
f
Intervention study.
g
Compared with no physically active friends.
h
Girls only.
i
For the purpose of increasing muscle but not for losing weight.
j
Compared with no or some physically active friends.
k
Distance <1 km.
l
Best friend only.
m
For 5 times/week.
1011 y
131
Jago et al.85
Social affiliation, do PA
Overall PA
X
MVPA
to be with friends
Jago et al.85
Social affiliation, do PA
1011 y
131
Both
Both
Finland
Finland
Finland
Both
Finland
1011 y
131
X
Light PA
to be with friends
Jago et al.85
Social affiliation, do PA
TABLE 1Continued
Both
Both
Both
Finland
Finland
109,111,116,120,122,123
Published online ahead of print May 16, 2013 | American Journal of Public Health
; engagement in
specic activities, such as weightbearing physical activity and
sports team participation (n =
11)53,54,68---70,80,98,99,101,114,123;
physical activity in specic contexts, such as leisure time or commuting to and from school (n =
10)93,94,97---100,68,110,111,123; physical
activity performed at a specic intensity, such as vigorous or moderate (n = 35)46,51,52,55,56,59--61,64,65,67,71,74,76,84,85,90--92,96,98,99,103,106---108,112---114,116--118,120,122,124
; and change in
any of these over time (n =
7).62,74,75,87,91,97,124 Vigorousintensity physical activities are
those that have an assigned metabolic expenditure value greater
than 6 (requires a large amount
of effort and causes rapid breathing or a substantial increase in
heart rate); moderate-intensity
physical activities have an
assigned metabolic expenditure of
3 to 6 (requires a noticeable
amount of effort and raises the
heart rate).126
We identied a priori and conrmed empirically from the literature 3 broad mechanisms
through which friends could inuence physical activity: friends
communication through social
norms and conversations about
physical activity (n = 55), including positive messaging, such as
encouragement and social support
(n = 54)46---55,58,62---64,68---72,75,76,
78,79,82,84,86,87,90---92,94,96,97,100,102-
111,114,115,117---120,122,123,113
SYSTEMATIC REVIEW
Communication About
Physical Activity
Communication about physical
activity most frequently consisted
of social support or friends encouragement for physical activity.
The items used to measure social
support generally described 1 or
more of the following behaviors:
friends reminding the respondent
to exercise, encouraging the respondent to engage in physical
activity, praising the respondent
for engaging in physical activity, or
discussing physical activity with
the respondent. Other indicators
of communication used in studies
(but not referred to as social support) included the respondents
perceptions of friends attitudes
and beliefs about physical activity
(such as the importance of physical
activity to the friend), respondentperceived inuence from friends
over their participation in physical
activity, and invitations to or from
a friend to engage in physical
activity together. Twenty-nine
studies used the Sallis et al. social
support scale125 to measure
friends inuence.46,47,49,51---53,55,
58,62,63,72,78,87,91,92,94,102,103,106,
107,109,114,117---120,122,124
This scale
incorporates measures of peer
encouragement and support for
physical activity, as well as 2
measures of participation in physical activity together: friends exercising with the respondent and
friends changing their schedule to
be active with the respondent.125
We categorized separate measures
of friends exercising with the respondent and of friends changing
their schedule to exercise with the
respondent as a combined measure of participation in physical
activity with a friend.
Of the 55 studies that investigated communication about or
social support for physical activity,
25 showed signicant positive
relationships in all models46---55,58,
62---64,69---72,75,76,78,79,82,84,96,
;
18 showed signicant associations in some models or some
groups within the population55,86,87,91,92,94,97,100,102---104,106,
107,109---111,113,124
; and 12 did not
show any signicant associations90,101,105,108,114,115,117---120,122,123
(including 1 focused on negative
messages101). One of the studies
with mixed results yielded an unexpected relationship: lower friend
social support at the beginning of
an intervention was associated with
a greater subsequent increase in
physical activity.124
The most common measures of
physical activity in these studies
were overall physical activity (n =
27)47---50,58,62---64,69,70,72,78,79,82,86,
87,90,96,102,105,107---109,111,120,122,123
and 6 studies
).
Four studies investigated negative messaging from friends about
physical activity, specically criticism for being active or exercising,
making fun of the respondent for
being active, declining an invitation from the respondent to be
active together, and the respondents belief that friends would
not be supportive of being active.86,91,101,119 None of these forms
of negative messaging were signicantly associated with respondents physical activity, which was
measured most often in these
studies with objective measures
(e.g., pedometer, accelerometer).86,91,119
Qualitative Studies
Qualitative studies can enhance
our understanding of the mechanisms through which friends could
inuence physical activity or
at least illustrate why children
American Journal of Public Health | Published online ahead of print May 16, 2013
SYSTEMATIC REVIEW
DISCUSSION
Physical inactivity is a strong
predictor of overweight, obesity,
and other chronic diseases.152
Numerous studies have investigated the determinants of physical
activity in children and adolescents, and social inuences have
been proposed as potentially important forces in determining
physical activity levels. Diverse
analytic approaches have been
taken to dene, measure, and understand social inuences. We
synthesized current ndings on
the ways friends may inuence
physical activity in childhood and
Published online ahead of print May 16, 2013 | American Journal of Public Health
Limitations
Because of the variation in indicators and study populations,
a meta-analysis of this body of
literature was not possible; the
large variability would have limited meta-analysis procedures to
small subsets of the studies. Our
review was limited to friendships
rather than broader social networks. This is because we expect,
in light of previous studies,24,28
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friendship inuence.45,62,74,
75,80,83,84,86,87,91,97,109,124
Conclusions
The value of the ndings from
the studies in our review comes
in part from understanding the
social processes that guide health
behavior and in part from exploring the possible use of social networks to promote healthy behaviors. We found extensive research
about and fairly strong evidence
of associations between physical
activity and friends behaviors.
The use of friendships to promote
physical activity in experiments or
interventions remains largely unexplored: only 1 study attempted
to manipulate the inuence of
friends in a controlled experiment;
it found that children biked longer
and more intensely in the presence of a friend than in the presence of an unknown peer.66 Only
1 study explored the impact of
friends social support for physical
activity in an intervention; it concluded that support from friends
predicted change in physical activity over time.124 It may be that
some interventions have been
unsuccessful in manipulating
physical activity through friendships and that those results have
not been published. However,
ndings from observational studies suggest that friends have potential to affect physical activity
American Journal of Public Health | Published online ahead of print May 16, 2013
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Contributors
C. C. Maturo conducted and documented
the literature searches. Both authors
evaluated studies and wrote the article.
Acknowledgments
This study was supported by the National
Institute of Diabetes and Digestive and
Kidney Diseases (grant R21DK081878).
We thank Elizabeth Vaquera and K.
M. Venkat Narayan for guidance and
comments and Melissa Matz for assistance
with searches.
Note. The content is solely the responsibility of the authors and does not
necessarily represent the ofcial views of
the National Institute of Diabetes and
Digestive and Kidney Diseases or the
National Institutes of Health.
References
1. Luke A, Dugas LR, Durazo-Arvizu RA,
Cao G, Cooper RS. Assessing physical activity and its relationship to cardiovascular
Published online ahead of print May 16, 2013 | American Journal of Public Health
28. Wilkinson RB. Best friend attachment versus peer attachment in the prediction of adolescent psychological
adjustment. J Adolesc. 2010;33(5):709--717.
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American Journal of Public Health | Published online ahead of print May 16, 2013
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Published online ahead of print May 16, 2013 | American Journal of Public Health
118. Hsu YW, Chou CP, NguyenRodriguez ST, McClain AD, Belcher BR,
Spruijt-Metz D. Inuences of social support, perceived barriers, and negative
meanings of physical activity on physical
activity in middle school students. J Phys
Act Health. 2011;8(2):210---219.
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166. Birch LL, Davison KK. Family environmental factors inuencing the developing behavioral controls of food intake
and childhood overweight. Pediatr Clin
North Am. 2001;48(4):893---907.
American Journal of Public Health | Published online ahead of print May 16, 2013
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