School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6-18

School of Nursing, McMaster University, Rm 3N25G, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 02/2009; DOI: 10.1002/14651858.CD007651
Source: PubMed

ABSTRACT The World Health Organization estimates that 1.9 million deaths worldwide are attributable to physical inactivity. Chronic diseases associated with physical inactivity include cancer, diabetes and coronary heart disease.
The purpose of this systematic review is to summarize the evidence of the effectiveness of school-based interventions in promoting physical activity and fitness in children and adolescents.
The search strategy included searching several databases. In addition, reference lists of included articles and background papers were reviewed for potentially relevant studies, as well as references from relevant Cochrane reviews. Primary authors of included studies were contacted as needed for additional information.
To be included, the intervention had to be relevant to public health practice, implemented, facilitated, or promoted by staff in local public health units, implemented in a school setting and aimed at increasing physical activity, report on outcomes for children and adolescents (aged 6 to 18 years), and use a prospective design with a control group.
Standardized tools were used by two independent reviewers to rate each study's methodological quality and for data extraction. Where discrepancies existed discussion occurred until consensus was reached. The results were summarized narratively due to wide variations in the populations, interventions evaluated and outcomes measured.
13,841 titles were identified and screened and 482 articles were retrieved. Multiple publications on the same project were combined and counted as one project, resulting in 395 distinct project accounts (studies). Of the 395 studies 104 were deemed relevant and of those, four were assessed as having strong methodological quality, 22 were of moderate quality and 78 were considered weak. In total 26 studies were included in the review. There is good evidence that school-based physical activity interventions have a positive impact on four of the nine outcome measures. Specifically positive effects were observed for duration of physical activity, television viewing, VO2 max, and blood cholesterol. Generally school-based interventions had no effect on leisure time physical activity rates, systolic and diastolic blood pressure, body mass index, and pulse rate. At a minimum, a combination of printed educational materials and changes to the school curriculum that promote physical activity result in positive effects.
Given that there are no harmful effects and that there is some evidence of positive effects on lifestyle behaviours and physical health status measures, ongoing physical activity promotion in schools is recommended at this time.

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    ABSTRACT: Atividade física e saúde na Educação Física escolar: efetividade de um ano do projeto "Educação Física +" Physical activity and health in school Physical Education programs: one-year effectiveness of the "Educação Física +" project Resumo O objetivo do presente estudo foi avaliar a efetividade do projeto "Educação Física +: Prati-cando Saúde na Escola" (EF+), desenvolvido a partir das aulas de Educação Física no ensino fundamental e médio da rede pública da cidade de Pelotas/RS. Quarenta escolas foram sor-teadas e alocadas nos grupos controle e intervenção. Os professores de Educação Física das escolas do grupo intervenção participaram do projeto EF+ no período de um ano letivo. As principais estratégias da intervenção foram: oficina de formação de professores; entrega de material didático aos professores; entrega de cartazes ilustrativos. Um questionário avaliou o nível de atividade física (≥300min/sem) e conhecimento (escore em uma prova) no início e no final da intervenção. Para verificar a adesão ao projeto, os professores foram entrevis-tados três vezes (duas entrevistas por telefone e uma presencial). No total, 4418 alunos par-ticiparam da coleta de dados nos dois períodos. Dos 39 professores convidados a participar do estudo, 19 aderiram ao projeto. Não houve alteração no nível de atividade física entre a coleta de linha de base e pós-intervenção, mas a média do conhecimento aumentou signifi-cativamente (3,1 para 3,7 pontos; p<0,05) no período. Concluiu-se que a proposta é factível e contribuiu para o aumento de conhecimento em saúde entre os alunos em curto espaço de tempo. Assim, espera-se que a saúde continue sendo tema das discussões na escola, con-tribuindo para as ações já existentes para toda população em termos de promoção da saúde. PalavRas-chave Atividade motora; Educação física; Estudos de intervenção. abstRact The aim of this study was to evaluate the effectiveness of the "Educação Fìsica +: Praticando Saúde na Escola" (EF+) intervention (in English: Physical Education +: Practicing Health at School), delivered through Physical Education classes at the primary and secondary schools levels in the public network of the city of Pelotas, Brazil. Forty schools were selected and randomly allocated to the control or intervention group. Physical Education teachers of schools allocated to the intervention group took part in the intervention for a full school year. The main intervention strategies included: workshop with the teachers; delivery of materials to the adopted during the classes; delivery of illustrative materials. Physical inactivity (<300 min/wk) and a score of knowledge about physical activity were assessed through questionnaire at baseline and after the intervention. In order to evaluate adherence to the project, teachers were interviewed three times during the school year (two telephone and one face-to-face interview). Overall, 4,418 students provided data at baseline and follow up. Of the 39 invited teachers, 19 adhered to the project. We found no changes in physical activity levels, but the knowledge score rose substantially and significantly (3.0 to 3.7; p<0.05). We concluded the project is doable and led to increases in the knowledge about physical activity and health in a short period of intervention. We believe health needs to continue being a topic of debate at school, complementing current health promotion efforts taking place outside the school settings.
    05/2014; 19(3):300-313. DOI:10.12820/rbafs.v.19n3p300
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    ABSTRACT: Urban environments can increase risk for development of obesity, insulin resistance (IR), and type 2 diabetes mellitus (T2DM) by limiting physical activity. This study examined, in a cohort of urban Hispanic youth, the relationship between daily physical activity (PA) measured by GPS, insulin resistance and cardiovascular fitness. Hispanic middle school children (n = 141) were assessed for body mass index (BMI), IR (homeostasis model [HOMA-IR]), cardiovascular fitness (progressive aerobic cardiovascular endurance run [PACER]). PA was measured (GPS-PA) and energy expenditure estimated (GPS-EE) utilizing a global positioning mapping device worn for up to 7 days. Students (mean age 12.7 ± 1.2 years, 52% female) spent 98% of waking time in sedentary activities, 1.7% in moderate intensity PA, and 0.3% in vigorous intensity. GPS analysis revealed extremely low amounts of physical movement during waking hours. The degree of low PA confounded correlation analysis with PACER or HOMA-IR. Levels of moderate and vigorous intensity PA, measured by GPS, were extremely low in these urban Hispanic youth, possibly contributing to high rates of obesity and IR. Physical movement patterns suggest barriers to PA in play options near home, transportation to school, and in school recess time. GPS technology can objectively and accurately evaluate initiatives designed to reduce obesity and its morbidities by increasing PA.
    International Journal of Pediatric Endocrinology 01/2014; 2014(1):25. DOI:10.1186/1687-9856-2014-25
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    ABSTRACT: Problem Statement: Active video gaming (AVG) provides physical activity or exercise through interactive play and has been shown to promote physical activity in school age children. However, most studies have compared AVG tasks to sedentary behaviors or unrelated tasks/sports in lab-based settings. Purpose: The purpose of this study was to examine 132 second and third grade (mean age = 8.18 ± 0.76) physical education students’ physical activity behavior and enjoyment during AVG and an equivalent traditional physical education striking activity. All students participated in two conditions during physical education classes: Wii© Tennis and a modified tennis activity. Step count was used to quantify physical activity and was measured with a Digiwalker SW 200 pedometer. A verbal questionnaire was administered to each participant immediately following participation in both conditions to assess enjoyment and preference. Results: Results indicated that participants accumulated significantly more steps in modified tennis compared to the Wii© Tennis (t=34.15, df = 131, p < 001). There were no significant sex differences in physical activity participation between the two conditions (p = .243). All of the students enjoyed Wii© Tennis and wanted to play again. Conclusions: Overall this study found that students’ physical activity participation was significantly higher in the ecological relevant modified tennis activity compared to the AVG condition. All of the students enjoyed participated in the AVG condition and 89% would choose it as a future option in physical education.

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