Abstract
Background: Physical inactivity among adolescents, particularly females in conservative societies like Saudi Arabia, poses significant risks to both physical and psychological health. Cultural norms, environmental constraints, and limited access to gender-appropriate sports facilities further exacerbate the problem. Understanding these factors is essential for developing effective, context-sensitive interventions. Aim: This study aimed to examine the relationship between daily physical activity behaviours and health outcomes, both physical and psychological, among adolescent females in Saudi Arabia. This paper also explores the impact of socio-environmental variables such as income, household size, and urban/rural residence on activity levels and wellbeing. Methods: A cross-sectional survey of 636 adolescent females aged 13-21 was conducted using validated instruments. The Physical Activity Questionnaire for Adolescents (PAQ-A) measured physical activity levels, and the Self-Rated Health (SRH) assessed psychological wellbeing and health-related quality of life. The analysis employed an Ordinal Logistic Model (OLM) guided by the Social Ecological Model (SEM) to assess predictors of physical activity participation. Results: The OLM results indicated that higher income levels, smaller household size, urban residence, and older age categories were significantly associated with higher levels of physical activity (p < 0.05). Participants with higher PAQ-A scores reported better psychological health and quality of life. The model showed a good fit, with a pseudo-R(2) of 0.36. Cultural and environmental barriers, particularly in rural areas, were identified as significant deterrents to participation. Conclusions: The findings highlight the urgent need for culturally adapted, gender-sensitive health promotion programs that target both individual and structural barriers to physical activity among adolescent girls in Saudi Arabia. Enhanced societal support and accessible sports infrastructure could significantly improve health outcomes and quality of life.