title: Does where you live matter? Leisure-time physical activity among Canadian youth: a multiple cross-sectional study.
abstract: BACKGROUND
  The aim of this study was to explore the population-wide distribution in the practice of leisure-time physical activity among Canadian youth and how physical activity level is influenced by contextual features of the environment.
  
  
  METHODS
  We studied the self-reported leisure-time physical activity of 54 832 Canadians aged 12 to 17 years. Observations were structured according to a 4-level geographic hierarchy. The outcome studied was a dichotomous indicator that referred to achieving (or not) the recommended daily level of leisure-time physical activity. To investigate the influence of the contextual features, we conducted multilevel logistic regressions.
  
  
  RESULTS
  For both girls and boys, significant variations were observed between health regions and between neighbourhoods within the provinces. Girls who lived in an urban setting showed lower odds of achieving the recommended physical activity level, as did those surveyed during the winter. Boys surveyed during the winter also showed lower odds of achieving the recommended level, but living in an urban setting had no effect on activity levels. Analysis of province-level residuals showed that girls living in Quebec were less likely to achieve the recommended activity level as compared with the national mean, and girls living in Ontario and British Columbia were more likely to achieve that threshold. Boys living in Ontario were more likely to achieve the recommended activity level as compared with the national mean. Youth had up to a 17% increased chance of achieving the recommended physical activity level if they lived in a context with a higher activity achievement level.
  
  
  CONCLUSIONS
  Leisure-time physical activity was associated with environmental factors at multiple geographic scales among Canadian youth. The variation was more important at the neighbourhood level. The results provide rationale for further investigation into how leisure-time physical activity is promoted in different contexts.
authors.affiliation: Quebec Heart and Lung Institute, Evaluation Platform on Obesity Prevention (Nadeau, Letarte, Fratu, Lebel); École supérieur d'aménagement du territoire et de développement régional (Nadeau, Letarte, Fratu, Waygood, Lebel), Laval University, Québec, Que.
authors.forename: Charles
authors.initials: C
authors.lastname: Nadeau
authors.affiliation: Quebec Heart and Lung Institute, Evaluation Platform on Obesity Prevention (Nadeau, Letarte, Fratu, Lebel); École supérieur d'aménagement du territoire et de développement régional (Nadeau, Letarte, Fratu, Waygood, Lebel), Laval University, Québec, Que.
authors.forename: Laurence
authors.initials: L
authors.lastname: Letarte
authors.affiliation: Quebec Heart and Lung Institute, Evaluation Platform on Obesity Prevention (Nadeau, Letarte, Fratu, Lebel); École supérieur d'aménagement du territoire et de développement régional (Nadeau, Letarte, Fratu, Waygood, Lebel), Laval University, Québec, Que.
authors.forename: Ramona
authors.initials: R
authors.lastname: Fratu
authors.affiliation: Quebec Heart and Lung Institute, Evaluation Platform on Obesity Prevention (Nadeau, Letarte, Fratu, Lebel); École supérieur d'aménagement du territoire et de développement régional (Nadeau, Letarte, Fratu, Waygood, Lebel), Laval University, Québec, Que.
authors.forename: E Owen D
authors.initials: EO
authors.lastname: Waygood
authors.affiliation: Quebec Heart and Lung Institute, Evaluation Platform on Obesity Prevention (Nadeau, Letarte, Fratu, Lebel); École supérieur d'aménagement du territoire et de développement régional (Nadeau, Letarte, Fratu, Waygood, Lebel), Laval University, Québec, Que.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Lebel