Physical Activity and Sports Participation Associates With Cognitive Functioning and Academic Progression: An Analysis Using the Combined 2017–2018 National Survey of Children’s Health

Abstract

Background:
The purpose of this study was to examine the independent and joint associations between physical activity (PA) and sports participation on academic performance variables within a representative sample of children and adolescents.

Methods:
Data were analyzed from the combined 2017-2018 National Survey of Children's Health. Household addresses were randomly selected within each US state. One household parent answered health and wellness questions pertaining to one randomly selected household child (N = 37,392; 48.1% female; 6- to 17-y old). Weighted logistic regression models were employed to examine the independent and joint associations between child PA frequency and sports participation with academic performance variables, adjusting for child- and family-level covariates.

Results:
Child PA frequency independently associated with 37% to 46% lower odds and child sports participation independently associated with 53% lower odds of reported difficulty concentrating, remembering, or making decisions (P < .001). For children who participated in sports, PA associated with 47% to 56% lower odds of ever repeating a grade level (P = .01).

Conclusions:
Frequency of weekly PA and sports participation independently and negatively associated with difficulty concentrating, remembering, and making decisions, whereas the negative association between PA and ever repeating a grade level differed by child sports participation status.

Full text

Physical Activity and Sports Participation Associates With Cognitive
Functioning and Academic Progression: An Analysis Using the
Combined 2017–2018 National Survey of Children’s Health
Ryan D. Burns, Yang Bai, and Timothy A. Brusseau
Background: The purpose of this study was to examine the independent and joint associations between physical activity (PA)
and sports participation on academic performance variables within a representative sample of children and adolescents.
Methods: Data were analyzed from the combined 2017–2018 National Survey of Children’s Health. Household addresses were
randomly selected within each US state. One household parent answered health and wellness questions pertaining to one
randomly selected household child (N = 37,392; 48.1% female; 6- to 17-y old). Weighted logistic regression models were
employed to examine the independent and joint associations between child PA frequency and sports participation with academic
performance variables, adjusting for child- and family-level covariates. Results: Child PA frequency independently associated
with 37% to 46% lower odds and child sports participation independently associated with 53% lower odds of reported difficulty
concentrating, remembering, or making decisions (P<.001). For children who participated in sports, PA associated with 47% to
56% lower odds of ever repeating a grade level (P= .01). Conclusions: Frequency of weekly PA and sports participation
independently and negatively associated with difficulty concentrating, remembering, and making decisions, whereas the negative
association between PA and ever repeating a grade level differed by child sports participation status.
Keywords:adolescent, behavioral science, pediatrics, survey research
Higher levels of physical activity (PA) have consistently been
shown to positively associate with a variety of academic perfor-
mance factors, including cognitive functioning, academic behavior,
and school grades.
1–3
The PA, particularly of higher intensities,
manifests physiological mechanisms at the cellular, molecular, and
structural level of the brain to improve cognitive skills,
4
including
enhancement of neurogenesis and central nervous system metabo-
lism.
5
In addition to impacting physiological mechanisms that may
improve cognitive skills,
6–8
PA may also impact behavior in the
academic classroom.
9–12
Potential mechanisms for these positive
effects on behavior may be due to moderatingpsychological arousal
yielding an internal psychological state conducive for learning,
possibly supplementing other physiological, cognitive, emotional,
and learning mechanisms.
13
Although the links between PA and academic performance have
been relatively well studied, much less is known regarding the
independent association between sports participation and academic
performance. Sport is an organized contest or game in which people
do certain PAs according to a specific set of rules to compete against
each other. In other words, sport participation includes structured
PAs characterized by specific rules and regulations.
14
Sport partici-
pation also provides exposure to social factors that are often not
present during unstructured PA. Sports participation provides op-
portunities to enhance task-specificself-efficacy, personal enjoy-
ment, prosocial behavior, and a sense of social support from coaches
and teammates.
15,16
These characteristics of sport participation may
lead to improvements in specific aspects of academic performance
above and beyond that provided by other modes of PA.
17,18
How-
ever, a paucity of work has compared both PA and sports participa-
tion on various aspects of academic performance variables while also
controlling for important factors at both the child and family level.
The yearly administered National Survey of Children’s Health
(NSCH) collects a variety of child- and family-level information
using a representative sample of US children and adolescents.
19,20
Specifically, the NSCH collects information pertaining to child
physical and mental health, child schooling (including indicators of
academic performance), the reported weekly frequency of a child
meeting the 60 minutes of daily PA recommendation, and whether
or not a child has participated in sports during the past
12 months.
19,20
The NSCH also collects important information
pertaining to the family, including adult education, family Federal
Poverty Level (FPL), and the family structure, all of which may
influence PA, sports participation, and/or academic perfor-
mance.
21–26
To the authors’knowledge, no study has examined
the independent and joint associations between PA and sports
participation in multiple variables related to academic performance
while concurrently controlling for important potential confounding
factors at both the child and family levels. Therefore, the purpose of
this study was to examine the independent and joint associations
between PA and sports participation on academic performance
variables within a representative sample of children and adoles-
cents from the combined 2017–2018 NSCH.
Methods
Participants
The participants were a nationally representative sample of chil-
dren and adolescents from the United States, aged 6- to 17-years
The authors are with the Department of Health and Kinesiology, The University of
Utah, Salt Lake City, UT, USA. Burns (ryan.d.burns@utah.edu) is corresponding
author.
1
Journal of Physical Activity and Health, (Ahead of Print)
https://doi.org/10.1123/jpah.2020-0148
© 2020 Human Kinetics, Inc. ORIGINAL RESEARCH

old, whose parents completed either the 2017 or the 2018 NSCH.
The NSCH is a national survey that is fielded annually by the US
Census Bureau and provides data on multiple aspects of child and
adolescent health and well-being. The data for the 2017 and 2018
NSCH were combined to provide opportunities for analyses using
variables with small sample sizes or low prevalence. A total of 52,129
surveys were completed for 2017 and 2018 combined, with 21,599
surveys completed in 2017 and 30,530 completed in 2018 for children
aged 0–17 years. The overall weighted response rate was 37.4% for
2017 and 43.1% for 2018. Children younger than 6 years old were
omitted from the current study because PA, sports participation, and
academic performance variables were only collected for children who
were 6- to 17-years old. Data from a total of 37,392 children and
adolescents (48.1% female; 6- to 11-y old = 15,896, 12- to 17-y
old = 21,496) were used in the current study. The NSCH data collec-
tion does not undergo an external institutional review board review.
Instead, the process for the review of methods and procedures for the
NSCH was incorporated into the responsibilities of the US Census
Bureau and Office of Management and Budget officials.
19,20
Procedures
Randomly selected US household addresses were mailed instruc-
tions to access the NSCH online. Addresses were randomly selected
within each US state and the District of Columbia. After 2 reminder
letters and postcard reminders tocomplete the NSCH online, house-
holds that had not accessed the online survey were mailed a paper
screening questionnaire.
19,20
An adult within the household was
asked to complete a web or paper screener questionnaire to identify
all children 0- to 17-years old who were living in the household. If a
child or children were reported to live in the household, adult
participants were directed to a detailed age- and web-based topical
questionnaire for one randomly selected household child. Adult
respondents completed 1 of 3 versions of the survey depending on
the child’sage:0–5 years, 6–11 years, and 12–17 years. The survey
topics included child and family demographics, child physical and
mental health status, family health and activities, and parental health
status, among others. Based on web keystroke data and paper
cognitive testing, the estimated survey length for households with-
out children was 5 minutes, and the estimated survey length for
households with children was 39 minutes.
19,20
Data Processing
The 2017–2018 NSCH combined data set contained 2 stratum
identifiers corresponding to the state of residence and an identifier
corresponding to households flagged with children.
19,20
The 2017–
2018 NSCH combined data set also included an adjusted proba-
bility weight variable that accounted for combining 2 years of
data.
19,20
Missing values for child demographic variables were
imputed using hot‐deck imputation, and the adult education,
household size, and poverty ratio missing values were imputed
using sequential regression imputation methods.
19,20
The dependent variables were 2 items on the NSCH that
aligned with cognitive functioning and academic progression,
which both constitute an academic performance. Aligned with
cognitive functioning, an item asked if the child has had “Serious
difficulty concentrating, remembering, or making decisions
because of a physical, mental, or emotional condition?”and was
binary coded (0 = no; 1 = yes). Academic progression aligned with
an item on the NSCH that asked about ever repeating a grade level,
“Since starting kindergarten, has this child repeated any grades?”
which was binary coded (0 =no; 1 = yes). Repeating a grade level
is a measure of academic achievement, as achieving a passing
grade is needed for progression within US schools.
The primary predictor variables were 2 items on the NSCH that
asked aboutchild PA and sports participation. The PA variable asked
“During thepast week, on how many days did this child exercise, play
a sport, or participate in physical activity for at least 60 minutes?”
Responses for this item ranged from 0 days (coded 0), 1 to 3 days
(coded 1), 4 to 6 days (coded 2), and every day (coded 3) and were
treated on the ordinal measurement scale. The sports performance
predictor variable asked “During the past 12 months, did this child
participate in a sports team or did he or she take sports lessons after
school or on the weekend?”Reponses for the sportsparticipation item
were binary-coded (0 = no participation; 1 = participation).
Important child- and family-level covariates were included in
the analysis to adjust for potential confounding associations. Child-
level covariates included child age (6–11 and 12–17 y), child sex
(female and male), child body mass index class (underweight,
normal weight, overweight, or obese), and child race/ethnicity
(White-non-Hispanic, Hispanic, Black-non-Hispanic, other/multira-
cial-non-Hispanic). Family-level covariates included items regarding
highest adult education within household (college degree or higher,
some college, high school/GED, less than high school), household
poverty level (400% FPL or greater, 200%–399% FPL, 100%–199%
FPL, 0%–99% FPL), and the family structure (2 married parents,
2 unmarried parents, single parent, and grandparent).
Statistical Analysis
To account for NSCH’s complex survey design and use of proba-
bility weights, the STATA survey prefix command “svy”was
employed to compute weighted prevalence within the descriptive
analysis and to compute appropriate variances and confidence
intervals within the primary analyses. Unweighted and weighted
prevalence statistics were computed for the PA and sports partici-
pation predictors in addition for the child- and family-level cov-
ariates. The primary analyses consisted of the use of weighted
simple and multiple logistic regression models to calculate crude
(unadjusted) and adjusted parameter estimates, respectively. Sepa-
rate models were run for each academic performance dependent
variable. Post hoc analyses were employed to examine the joint
associations (interactions) between child PA and sports participa-
tion on each academic performance variable to determine if
the association between PA and a respective dependent variable
differed according to sport participation status. To test for age and
sex effect modification, subpopulation analyses were employed
within the adjusted models using STATA’s“svy, subpop:”prefix
command. Communication of the results involved the reporting of
odds ratios with the associated 95% confidence intervals. The 2-
sided alpha level was set at P<.05, and all analyses were con-
ducted using STATA statistical software package (version 15.0;
StataCorp, College Station, TX).
Results
Unweighted and weighted prevalence for all variables are
reported in Table 1. During the past 12 months, approximately
10.1% (weighted prevalence = 9.6%) of the parents reported that
their child has had serious difficulty concentrating, remembering,
or making decisions, and 5.4% (weighted prevalence = 6.3%)
reported that their child ever repeated a grade level. Approximately
(Ahead of Print)
2Burns, Bai, and Brusseau

21.0% (weighted prevalence = 22.6%) of the parents reported that
their child engaged in 60 minutes of PA every day during the past
week, and approximately 63.9% (weighted prevalence = 57.7%) of
the parents reported that their child participated in sports during the
past 12 months.
Table 2presents the unadjusted crude odds ratios for predicting
each academic performance dependent variable. Any reported child
weekly PA frequency associated with 47% to 64% lower odds of
child difficulty concentrating, remembering, or making decisions
compared with no reported child PA (P<.001). Child sports partici-
pation associated with 58% lower odds of reported difficulty concen-
trating, remembering, or making decisions compared with reported no
sports participation (P<.001). In addition, reported child PA of 4 to
6 days per week associated with 37% lower odds of ever repeating a
grade level (P<.001), and sports participation associated with 39%
lower odds of ever repeating a grade level (P<.001).
Table 3presents the adjusted odds ratios for predicting each
academic performance dependent variable. Afteradjusting for child-
and family-level covariates, weekly child PA independently associ-
ated with 37% to 46% lower odds of difficulty concentrating,
remembering, or making decisions. Likewise, after adjusting for
child- and family-level covariates, child sports participation during
the past 12 months independently associated with 53% lower odds
of difficulty concentrating, remembering, or making decisions. No
age or sex effect modification was found using the cognitive
functioning outcome. In addition, after covariate adjustment, re-
ported weekly child PA and child sports participation during the past
12 months did not independently associate with ever repeating a
grade level using the total sample. However, the relationship
between sports participation and academic progression was moder-
ated by age, as sports participation associated with 26% lower odds
of ever repeating a grade level in 12- to 17-year-old adolescents
Table 1 Counts, Unweighted Prevalence, and Weighted Prevalence Statistics for All Observed Variables
Variable Level Count Unweighted % Weighted %
Difficulty concentrating, remembering, making decisions No 33,270 89.9 90.4
Yes 3748 10.1 9.6
Repeated a grade level No 34,876 94.6 93.7
Yes 2008 5.4 6.3
60 min of PA 0 D 3312 9.0 9.5
1–3 d/wk 14,301 38.7 39.9
4–6 d/wk 11,600 31.3 28.2
Every day per week 7767 21.0 22.6
Sports participation Did not participate 13,270 36.1 42.3
Participated 23,509 63.9 57.7
Child age 6- to 11-y old 15,896 42.5 50.0
12- to 17-y old 21,496 57.5 50.0
Child sex Male 19,415 51.9 51.1
Female 17,977 48.8 48.9
Child BMI class Normal weight 17,310 65.9 62.5
Underweight 1701 6.5 6.7
Overweight/obese 7255 27.6 30.8
Child race/ethnicity White/non-Hispanic 25,867 69.2 49.9
Hispanic 4377 11.7 25.7
Black/non-Hispanic 2497 6.7 14.3
Other/multiracial-non-Hispanic 4651 12.4 10.1
Highest adult education College degree or higher 22,195 59.4 47.3
Some college 9063 24.3 22.3
High school/GED 5127 13.7 19.8
Less than high school 1007 2.7 10.6
Household poverty level 0%–99% FPL 4566 12.2 20.2
100%–199% FPL 5884 15.7 21.7
200%–399% FPL 11,248 30.8 27.1
400% FPL or greater 15,694 42.0 31.0
Family structure 2 married parents 25,744 70.3 64.7
2 unmarried parents 2239 6.1 8.0
Single parent 7108 19.3 21.3
Grandparent household 1262 3.4 4.4
Abbreviations: BMI, body mass index; FPL, federal poverty level; GED, General Educational Development; PA, physical activity.
(Ahead of Print)
Physical Activity and Sports Participation 3

(P= .049) but not in 6- to 11-year-old children. No sex effect
modification was found using the academic progression outcome.
Post hoc analyses consisted of testing the joint associations
(interactions) between reported child PA and sports participation
on each academic performance dependent variable. Covariates that
were found to be statistically significant within the respective
adjusted models were controlled for within each post hoc analysis.
There was a statistically significant joint association between child
PA and sports participation on ever repeating a grade level. The
results of this post hoc analysis are illustrated in Figure 1. If a child
did not participate in sports within the past 12 months, PA did not
significantly associate with ever repeating a grade level. However,
among children who were reported to have participated in sports
during the past 12 months, reported weekly child PA associated
with lower odds of ever repeating a grade level compared with no
reported child PA (OR
1–3d
= 0.52, P
1–3d
= .004; OR
4–6d
= 0.44,
P
4–6d
= .001; OR
Every day
= 0.53, P
Every day
= .003).
Discussion
The purpose of this study was to examine the independent and joint
associations between PA and sports participation on academic
performance variables within a representative sample of US children
and adolescents. After controlling for important child- and family-
level covariates, any frequency of child PA during the past week and
sports participation during the past 12 months associated with lower
odds of reported difficulty concentrating, remembering, or making
decisions. Interestingly, sports participation moderated the associa-
tion between child PA frequency and ever repeating a grade level as
any frequency of weekly PA associated with lower odds of ever
repeating a grade level only in those children who participated in
sports. An interpretation of these results and a discussion of potential
future research directions are provided.
Previous research has shown that higher levels of PA associ-
ates with specific aspects of academic performance in children and
Table 2 Crude Parameter Estimates Predicting Academic Performance Variables Using Weighted Simple Logistic
Regression
Predictor Level
Difficulty concentrating,
remembering, making decisions
(no = referent)
crude OR (95% CI)
Repeated a grade level
(no = referent)
crude OR (95% CI)
60 min of PA 0 days Referent Referent
1–3 d/wk 0.53
†
(0.42–0.67) 0.83 (0.62–1.11)
4–6 d/wk 0.36
†
(0.28–0.46) 0.63
†
(0.46–0.87)
Every day per week 0.45
†
(0.34–0.59) 0.93 (0.68–1.28)
Sports participation Did not participate Referent Referent
Participated 0.42
†
(0.37–0.49) 0.61
†
(0.51–0.74)
Child age 6- to 11-y old Referent Referent
12- to 17-y old 0.97 (0.84–1.13) 1.63
†
(1.35–1.98)
Child sex Male Referent Referent
Female 0.58
†
(0.50–0.68) 0.66
†
(0.54–0.80)
Child BMI class Normal weight Referent Referent
Underweight 1.59
†
(1.19–2.11) 1.40 (0.95–2.07)
Overweight/obese 1.38
†
(1.15–1.66) 1.45
†
(1.14–1.84)
Child race/ethnicity White/non-Hispanic Referent Referent
Hispanic 0.76 (0.76–1.22) 1.61
†
(1.26–2.06)
Black/non-Hispanic 1.26
†
(1.01–1.57) 2.10
†
(1.66–2.64)
Other/multiracial-non-Hispanic 0.87 (0.71–1.07) 1.07 (0.80–1.44)
Highest adult education College degree or higher Referent Referent
Some college 1.57
†
(1.33–1.84) 2.14
†
(1.74–2.62)
High school/GED 1.70
†
(1.41–2.06) 3.08
†
(2.46–3.87)
Less than high school 1.52
†
(1.06–2.18) 3.71
†
(2.62–5.27)
Household poverty level 0%–99% FPL Referent Referent
100%–199% FPL 0.80 (0.63–1.02) 0.78 (0.60–1.02)
200%–399% FPL 0.55
†
(0.44–0.69) 0.44
†
(0.34–0.58)
400% FPL or greater 0.43
†
(0.35–0.54) 0.28
†
(0.23–0.36)
Family structure 2 married parents Referent Referent
2 unmarried parents 1.87
†
(1.36–2.58) 1.97
†
(1.43–2.71)
Single parent 1.69
†
(1.43–1.99) 1.96
†
(1.58–2.44)
Grandparent household 2.48
†
(1.73–3.55) 3.34
†
(2.33–4.78)
Abbreviations: BMI, body mass index; FPL, Federal Poverty Level; GED, General Educational Development; OR, odds ratio; PA, physical activity; 95% CI, 95%
confidence interval. Note: Bold values indicate the statistical significance and
†
statistical significance, P<.05.
(Ahead of Print)
4Burns, Bai, and Brusseau

adolescents.
27–29
However, not all research shows this favorable
pattern with null associations observed in a number of longitudinal
and experimental studies.
30–32
Singh et al
32
found that between
48% and 60% of high-quality studies showed a beneficial impact of
PA on specific academic performance variables. However, 6 out of
7 high-quality studies (86%) showed a beneficial effect of PA on
mathematics performance.
32
These contrasting results from previ-
ous work highlight that there may be important moderators and
mediators of effect when considering the relationship between PA
and academic performance and that this relationship also differs by
the type of academic outcomes examined (eg, cognitive skills,
behavior, and subject achievement). The novelty of the current
study is the consideration of multiple aspects of academic perfor-
mance and examination of both PA and sports participation
together within the analysis. The results of this study indicate
that both PA and sports participation are independently associated
with lower odds of difficulty concentrating, remembering, and
making decisions, an item on the NSCH that relates to executive
control, which is a core cognitive process including inhibition,
working memory, and cognitive flexibility.
33,34
These cognitive
skills are needed to complete complex goal-directed cognitive tasks
that are often undertaken in academic settings.
The results support prior research identifying the role of PA on
specific cognitive skills and also show that this relationship is
independent of sports participation and several child- and family-
level potential confounding variables.
27,35
The current study also
found an independent association between sports participation and
cognitive functioning, a relationship found in other work,
36–39
and
an independent association between sports participation and aca-
demic progression in older adolescents only. Bang et al
37
found that
sports participation had positive effects on locus of control, or how
well an individual feels that they are in control of their life, which
may contribute to better academic performance. This improved
locus of control may relate to the structured characteristic of sports
participation. The social aspect of sports participation also may
improve social ties between individuals and limit antisocial
Table 3 Adjusted Parameter Estimates Predicting Academic Performance Variables Using Weighted Multiple
Logistic Regression
Predictor Level
Difficulty concentrating,
remembering, making decisions
(no = referent)
adjusted OR (95% CI)
Repeated a grade level
(no = referent)
adjusted OR (95% CI)
60 min of PA 0 days Referent Referent
1–3 d/wk 0.63
†
(0.49–0.79) 1.02 (0.73–1.44)
4–6 d/wk 0.52
†
(0.39–0.71) 1.00 (0.65–1.52)
Every day per week 0.54
†
(0.39–0.76) 1.20 (0.80–1.82)
Sports participation Did not participate Referent Referent
Participated 0.47
†
(0.39–0.57) 0.84 (0.63–1.11)
Child age 6- to 11-y old Referent Referent
12- to 17-y old 0.83 (0.66–1.05) 1.18 (0.88–1.60)
Child sex Male Referent Referent
Female 0.55
†
(0.45–0.66) 0.65
†
(0.51–0.82)
Child BMI class Normal weight Referent Referent
Underweight 1.39
†
(1.02–1.89) 1.13 (0.72–1.77)
Overweight/obese 1.14 (0.93–1.39) 1.14 (0.89–1.48)
Child race/ethnicity White/non-Hispanic Referent Referent
Hispanic 0.96 (0.57–1.01) 1.08 (0.80–1.46)
Black/non-Hispanic 0.85 (0.66–1.10) 1.44
†
(1.07–1.94)
Other/multiracial-non-Hispanic 0.79 (0.61–1.03) 1.11 (0.78–1.59)
Highest adult education College degree or higher Referent Referent
Some college 1.21 (0.99–1.48) 1.69
†
(1.32–2.16)
High school/GED 0.98 (0.75–1.29) 1.90
†
(1.41–2.56)
Less than high school 0.81 (0.48–1.36) 2.22
†
(1.35–3.62)
Household poverty level 0%–99% FPL Referent Referent
100%–199% FPL 0.93 (0.66–1.28) 0.81 (0.58–1.17)
200%–399% FPL 0.70
†
(0.53–0.93) 0.56
†
(0.40–0.79)
400% FPL or greater 0.73
†
(0.56–0.96) 0.50
†
(0.36–0.67)
Family structure 2 married parents Referent Referent
2 unmarried parents 1.44 (0.95–2.17) 1.35 (0.89–2.05)
Single parent 1.38
†
(1.12–1.70) 1.22 (0.94–1.61)
Grandparent household 1.73
†
(1.15–2.61) 2.47
†
(1.54–3.95)
Abbreviations: BMI, body mass index; FPL, Federal Poverty Level; GED, General Educational Development; OR, odds ratio; PA, physical activity; 95% CI, 95%
confidence interval. Note: Bold values denote the statistical significance and
†
statistical significance, P<.05.
(Ahead of Print)
Physical Activity and Sports Participation 5

behaviors within individuals.
40,41
These social relations may, in
turn, promote self-confidence, social interactions, and reciprocal
modeling and learning among higher-achieving individuals.
40,41
Thus, both the structured and social characteristics of sport may
positively influence the skills needed for academic success. How-
ever, the independent association between sports participation and
academic progression was only found in older adolescents. A
possible mechanism for this may be that within the higher grade
levels, adolescents who fail a grade may not be allowed to
participate in sports. In addition, athletes who compete in highly
competitive sports programs may enroll in less challenging course-
work to cope with concurrent academic and athletic priorities.
These plausible mechanisms suggest potential bidirectionality
between sports participation and academic progression and,
thus, it should be explored with future research.
A novel result found from this study was the joint association
between reported PA frequency and sports participation with ever
repeating a grade level. Children who participated in any frequency
of PA and participated in sports had lower odds of ever repeating a
grade level. The PA did not associate with repeating a grade level if
the child did not participate in sports. Domazet et al
40
examined if
PA, sports participation, or active commuting associated with
mathematics performance and inhibitory control in a sample of
adolescents. The PA’s associations with academic performance were
mixed, but sports participation significantly associated with higher
mathematics performance.
41
However, no joint associations were
tested. Fox et al
41
also examined the associations between PA and
sports team participation on grade point average among middle- and
high-school students and found that both PA and sports participation
had significant associations with grade point average with the
associations differing by grade level and sex. Again, however, joint
associations between PA and sports participation were not tested.
41
The statistically significant joint associations in the current study
suggests, perhaps, that structured PA with social relations, as seen in
sports, is a type of PA that may more strongly influence academic
achievement. To the authors’knowledge, this is the first study to
observe these findings. Despite the statistical control for a number of
child- and family-level covariates, this joint association should be
interpreted with caution because of the cross-sectional design and
use of survey methods for data collection. However, this unique
finding could spur additional research.
This study provides an evidence of both independent and joint
associations between reported PA and sports participation with
specific aspects of academic performance. However, the broadness
of the PA and sports participation items on the NSCH manifests a
need for additional research on these associations. Specifically,
examining the intensity of PA and participation in different types of
sports (eg, team vs individual) will provide important and specific
information. Possible other factors to consider within these rela-
tionships are the time segment characteristics of these behaviors
(eg, weekday, weekend, in school, out of school), how relative time
use of PA intensity associates with specific aspects of academic
performance within a compositional data analytic framework, the
frequency of sports participation, and the interaction between
motor skill competency, sports participation, and academic perfor-
mance. Studies have also shown that children from lower income
households have a lower prevalence of sports participation com-
pared with children from higher income households.
42
Using the
current 2017–2018 NSCH sample, there was a relationship
between family poverty level and sports participation, as house-
holds at 400% FPL or greater had 4.8 times greater odds of child
sports participation compared with households at 0% to 100% of
FPL. Family poverty level was controlled for within the analyses in
the current study; however, the strong association between family
poverty level and sports participation provides additional evidence
for the imperative need to provide sports participation opportunities
for children within lower income families. Important socioenvir-
onmental facilitators to provide these opportunities may be parents
and peers, which may mitigate barriers for children’s sport
participation.
43
Most importantly, examining these associations
using longitudinal and experimental research designs will provide
evidence for causal influences, and testing for bidirectional
Figure 1 —Joint association of reported weekly child PA frequency and sports participation on adjusted ORs of ever repeating a grade level. Note:
odds ratio referent = 1; odds ratios adjusted for child sex, race/ethnicity, adult education, family Federal Poverty Level, and family structure. OR indicates
odds ratio; PA, physical activity.
†
Statistical differences in odds ratios between sport participation groups within a respective PA stratum, P<.05.
(Ahead of Print)
6Burns, Bai, and Brusseau

relationships among these constructs using cross-lagged panel
models may have merit.
This study has several strengths to highlight. First, this study
included a large and representative sample of US children and
adolescents; thus, the generalizability of findings from this study
is not limited. Second, this study included 2 separate dependent
variables that constitute academic performance. The study also
examined the influence of both PA and sports participation on
academic performance; most studies tend to examine only one of
these explanatory/predictor variables. Third, the associations exam-
ined in this study were adjusted for a number of child- and family-
level covariates, attenuating the potential confounding influence of
these factors. Finally, the analyses conducted in this study included
the combined data from 2 consecutive years of the NSCH, which
improves statistical power and provides more precise parameter
estimates compared with the use of 1-year data. Limitations of the
current study included the use of parent self-report, which may be
subject to both recall and response bias. The NSCH is an annual
cross-sectional survey; therefore, all relationships are correlational
and no causal inferences can be made. In addition, the PA dependent
variable only asked about meeting the weekly frequency of the 60-
minute-per-day guideline but did not specifically ask about PA
intensity. Finally, the academic performance variables were dichot-
omized for analysis, precluding trend analyses across multiple levels
of a respective variable and the examination of possible U-shaped
associations within the data.
Conclusions
This study provided information on the relationships among PA,
sports participation, and academic performance within a represen-
tative sample of US children and adolescents. Both PA and sports
participation independently and negatively associated with re-
ported difficulty concentrating, remembering, or making decisions.
Most interestingly, the negative relationship between PA and
repeating a grade level was moderated by sports participation;
that is, any reported weekly PA associated with lower odds of
repeating a grade level in children who participated in sports. These
results indicate that PA and sports participation both may influence
specific aspects of a child’s academic performance. Future research
should examine these associations using more objective measures
within longitudinal and experimental research designs. Determin-
ing the types of sports that may more strongly influence academic
performance may also have merit in future work. Both PA and
sports participation should be considered when utilizing move-
ment-based behaviors to improve specific aspects of academic
performance in youth.
Acknowledgments
The authors would like to thank the parents who participated in either the
2017 or the 2018 NSCH. No funding was received for this study.
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