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

Neil-Sztramko, SE et al (2021)

Cochrane Database of Systematic Reviews - 10.1002/14651858.CD007651.pub3.

Evidence Categories

  • Care setting: Other settings
  • Care setting: School Setting
  • Population group: Children & Adolescents
  • Intervention: Education Interventions
  • Intervention: Behaviour Change Interventions
  • Intervention: Multicomponent physical activity interventions
  • Outcome: Change in physical activity

Type of Evidence

Systematic Review

Aims

"The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; to evaluate the effects of school-based interventions on improving body composition; and to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population."

Findings

"Based on the three new inclusion criteria, 16 of the 44 studies included in the previous version of this review were excluded. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean diCerence (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence).

School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO2max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m2 (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). Whether school-based physical activity interventions impact health-related quality of life or adverse events is uncertain."

Conclusions

"Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects,the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously."