The relationship between physical activity, sleep, and coping skills among adolescent vocational students, and the effects of a physical education-based coping training

Background and aims
Adolescence is defined as a vulnerable period characterized by several physiological and psychosocial changes that affect health and behavior. Although most adolescents successfully manage the transition between childhood and adulthood, the speed and magnitude of these changes exceed the coping abilities of a significant amount of young people. Furthermore, due to the important role of sleep within the stress−health relationship, research draws attention to the maturational sleep changes in adolescence. One study showed that impaired sleep increased the risk for poor psychological well-being. In contrast, sleep disturbances may also result from higher stress levels. However, research on the relationship between stress, coping and sleep among vocational students is scarce. This is surprising, given that 74% of all secondary school diplomas in Switzerland are granted to students with vocational education and training (VET). Therefore, the aim was to implement a physical education-based coping training (EPHECT) among two vocational schools and to evaluate effects on perceived stress, coping and sleep.
Thus, the aims of this thesis were to summarize the state of the art of physical activity and sleep among adolescents, to assess the prevalence and correlates of sleep complaints, physical activity and psychological well-being among adolescent vocational students and to find out whether a physical education-based coping training can increase psychological functioning (short and medium-term effects).
Methods
A quasi-experimental approach was adopted for the pilot (EPHECT I) and the follow-up study (EPHECT II). Possible intervention effects on stress, coping and sleep between pre- and post-intervention (EPHECT I and EPHECT II) and 6-months follow-up (EPHECT II) were assessed.
EPHECT I: Two comparable vocational schools participated in the study, and one of them received the intervention program, while the other school maintained regular physical education (PE) classes (N = 1244 students: M = 17.98 yrs.; SD = 1.36; 531 females). All participants completed a battery of self-report psychological questionnaires (assessing perceived stress, coping skills, sleep quality, and physical activity). In addition, physical activity and sleep were objectively measured (actigraphy, EEG) within a subsample (n = 56).
EPHECT II: In the follow-up study (N = 131), 64 students from four classes received EPHECT during physical education (PE) class, while the CG (n = 67) had conventional PE class. The psychological questionnaires were administered again to all students pre- and post-intervention.
Results
The meta-analysis showed that differences in assessment methods and poor correlation between subjective and objective measurement make it difficult to compare data from different studies. Only one study compared subjective and objective assessments for both sleep and exercise; therefore, more research is need to close gaps in knowledge, such as regarding the aims of the meta-analysis, which was not reached completely, namely whether the assessment tool influences the results. In general, it was found that adolescents who exercise more report better sleep. However, physical activity (PA) and sleep onset latency (SOL) are frequently overestimated, while total sleep time (TST) is frequently underestimated. Additionally, it was found that females tend to be less active than males.
EPHECT I confirmed the findings that TST is frequently under-estimated and physical activity and SOL are over-estimated and that females are less active than males. The study also showed that students of the intervention group with initial lower life satisfaction showed a reduction in maladaptive coping strategies. However, the implementation rate did not moderate the findings. As the study had problems with teacher compliance and subsequent student motivation, an improved version of EPHECT was therefore designed and implemented in a few classes only (EPHECT II). EPHECT II showed much better teacher compliance and findings revealed improvements of adaptive coping skills in IG students. The six-month follow-up showed decreased levels of perceived stress in IG students compared to CG and to baseline, an effect that was not detectable at the end of the intervention. A path analysis suggested an indirect effect on stress perception at follow-up via improved adaptive coping skills.
Conclusion
The presented studies within this thesis provide an important basis toward future investigations targeting the relationship between physical activity and sleep. A physical education-based training program with the goal of fostering adaptive coping skills and reducing maladaptive coping strategies and stress perception was developed, which can be implemented in a time-efficient manner into the existing PE-syllabus of vocational schools. This program has the potential to reduce future stress in adolescents who are in a vulnerable phase of transition and enable them to become a valuable part of their communities and society in general.