Original Research Characteristics of Canadian Youth Adhering to Physical Activity and Screen Time Recommendations Caroline Fitzpatrick, PhD 1,2,3 , Robin Burkhalter, MMath 4 , and Mark Asbridge, PhD 5,6 Abstract The purpose of the study was to describe adherence to screen time (ST) and physical activity (PA) recommendations among Canadian youth. The present study was based on a representative sample of Canadian students from Grades 7 through 12 (N ¼ 47,203). ST and PA as well as demographic (gender, ethnicity, grade, and province of residence) and individual (alcohol, tobacco and cannabis usage, school connectedness) correlates were self-reported by youth. In total, 49.2% (99% confidence interval [CI] ¼ [46.3%, 52.2%]) of participants respected none of the recommendations, while 40.2% (99% CI [37.0%, 43.3%]) and 20.8% (99% CI [19.2%, 22.4%]) respected PA or ST recommendations, respectively. In terms of the correlates of health- related behavior, White ethnicity, alcohol use, and feeling more connected to school were positively correlated with adherence. Attending school in Quebec and smoking cannabis increased risk of poor compliance. The present findings may help the design of school-based health promotion strategies designed to increase PA and reduce ST. Keywords screen time, physical activity, guidelines, health-related behavior, school connectedness, school nursing Poor lifestyle habits during adolescence can pave the way for poor heath in adulthood creating a pattern that is costly for both the individual and society. For instance, adolescent sedentary behavior contributes to the development of chronic metabolic disease, reduced fitness, lower self-esteem, and depressive symptoms (Colley et al., 2013; Liu, Wu, & Yao, 2016; Tremblay, Colley, Saunders, Healey, & Owen, 2010). Although all forms of sedentary behavior may present health risks, screen time (ST) may be particularly detrimental because it has been additionally linked to a range of health, socioemotional, and academic impairments (Faught et al., 2017; Herman, Hopman, & Sabiston, 2015; Pagani, Fitzpa- trick, Barnett, & Dubow, 2010). Independent of time spent sedentary, the amount of physical activity (PA) youth engage in, has also been linked to better mental and physical health outcomes, especially when the activity is of moderate to high intensity (Biddle & Asare, 2011; Janssen & LeBlanc, 2010). Unfortunately, research suggests that a large proportion of Canadian youth fail to engage in enough PA and spend too much time with screens (Janssen, Roberts, & Thompson, 2017). Estimates suggest that between 50% and 80% of Canadian youth between the ages of 11 and 17 exceed the recommended maximum of 2 hr of daily ST beyond school work, while 31.2% fail to achieve the minimum daily rec- ommendation of 1 hr per day of PA (Leatherdale & Ahmed, 2011; Leatherdale & Rynard, 2013). The Canadian Society for Exercise Physiology’s most recent guidelines further emphasize the importance of jointly examining youth adher- ence to ST and PA recommendations (Tremblay et al., 2016). In particular, youth who simultaneously exceed rec- ommendations of ST and fail to meet recommendations of PA may be of specific interest as they are exposed to a “double dose” of risk. In order to develop effective targeted interventions, it remains important to understand which adolescents are most at risk of engaging in excessive ST and insufficient PA or a 1 De ´partement des sciences humaines, Universite ´ Sainte-Anne, Church Point, Nova Scotia, Canada 2 PERFORM Centre, Concordia University, Montreal, Quebec, Canada 3 Center for Education Practice Research, University of Johannesburg, Gauteng, South Africa 4 Propel Centre for Population Health Impact, University of Waterloo, Ontario, Canada 5 Department of Community Health and Epidemiology, Dalhousie Uni- versity, Halifax, Nova Scotia, Canada 6 Department of Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Corresponding Author: Caroline Fitzpatrick, PhD, De ´partement des sciences humaines, Universite ´ Sainte-Anne, Church Point, Nova Scotia, Canada B0W 1M0. Email: caroline.fitzpatrick@usainteanne.ca The Journal of School Nursing 1-10 ª The Author(s) 2019 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1059840519881185 journals.sagepub.com/home/jsn