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Systematic Review
"This systematic review aimed to assess the effectiveness, cost-effectiveness and associated adverse events of interventions designed to increase physical activity in children aged 4 to 12 years in outside-school hours childcare settings."
"The review included nine trials with 4458 participants. Five trials examined the effectiveness of staff‐based interventions to change practice in the outside‐school hours childcare setting (e.g. change in programming, activities offered by staff, staff facilitation/training).
Two trials examined the effectiveness of staff‐ and parent‐based interventions. There was low‐certainty evidence that physical activity interventions may have little to no effect on total daily moderate‐to‐vigorous physical activity compared to no intervention (MD 1.7 minutes, 95% CI –0.42 to 3.82; P = 0.12; 6 trials; 3042 children).
There was low‐certainty evidence that physical activity interventions may lead to little to no reduction in body mass index (BMI) as a measure of cardiovascular health, compared to no intervention (SMD –0.17, 95% CI –0.44 to 0.10; P = 0.22; 4 trials, 1684 children).
Physical activity interventions that were delivered online were more cost‐effective than in person. Combined results suggest that staff‐and‐parent and staff‐and‐child‐based interventions may lead to a small increase in overall daily physical activity and a small reduction or no difference in BMI."
"Although the review included nine trials, the evidence for how to increase children's physical activity in outside‐school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. Of the types of interventions identified, when assessed using GRADE there was low‐certainty evidence that multi‐component interventions, with a specific physical activity goal may have a small increase in daily moderate‐to‐vigorous physical activity and a slight reduction in BMI. There was very low‐certainty evidence that interventions increase cardiovascular fitness. By contrast there was moderate‐certainty evidence that interventions were effective for increasing proportion of time spent in moderate‐to‐vigorous physical activity, and online training is cost‐effective."