Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Active Recess

Intervention Description: Direct observations were conducted during recess before the redesign in May 2014, then again at 6 months and 1 year after the redesign. During each observation, observers scanned the playground and counted how many students were sedentary, engaged in moderate activity, or engaged in vigorous activity. System for Observing Play and Leisure Activity in Youth, a validated instrument for observing physical activity in free play settings, was used to collect observation data.

Intervention Results: Six months from baseline, the percentage of children engaging in moderate to vigorous physical activity during recess increased by 23.3%, and the percentage engaged in vigorous physical activity increased by 26.2%. These increases were sustained at 1 year from baseline, with an increase of 17.2% for moderate to vigorous physical activity and 33.1% for vigorous physical activity. Chi-square tests of independence showed that changes in the proportion of students engaging in moderate to vigorous physical activity and vigorous physical activity were statistically significant (p<0.01).

Conclusion: This evaluation demonstrated that environmental interventions involving the provision of structural and loose play equipment can be implemented in an intermediate school setting, and can create a sustainable increase in physical activity among students during recess. This example also demonstrates that schools and community organizations can evaluate the impact of these interventions using relatively simple, low-cost observational methods.

Study Design: Pre-post design

Setting: 1 elementary school

Population of Focus: Students in 5th and 6th grade

Data Source: Direct observation data were collected using System for Observing Play and Leisure Activity in Youth (SOPLAY)

Sample Size: 148 students

Age Range: Ages 10-12 (5th & 6th grade)

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Active Recess

Intervention Description: Three schools were randomly selected by an intervention group in Bogotá, Colombia, in 2013: Intervention (Active Module of Active Recess - MARA) + Text Messages (SMS) (MARA+SMS group), intervention (MARA group), control (control group). Intervention was implemented for ten weeks. The duration and intensity of physical activity and sedentary behaviors were measured objectively using accelerometers Actigraph-GT3X+. Adiposity was measured by body mass index and fat percentage. We measured at baseline (T0) and during the tenth week of intervention (T1). We evaluated the effect of the intervention using a difference-in-difference analysis (DID).

Intervention Results: We included 120 students (57.5% girls; mean age = 10.5 years; standard deviation [SD] = 0.64). There was a significant increase in the mean daily minutes of moderate to vigorous physical activity in the MARA group (Difference T1-T0 = 6.1 minutes, standard error [SE] = 3.49, p = 0.005) in relation to the control group. There were no significant changes in the minutes of moderate to vigorous physical activity in the MARA+SMS group (Difference T1-T0 = -1.0 minute; SE = 3.06; p = 0.363). The minutes decreased in the control group (Difference T1-T0 = -7.7 minutes; SE = 3.15; p = 0.011). The minutes of sedentary behaviors decreased in the MARA and MARA+SMS groups and increased in the control group (MARA Difference T1-T0 = -15.8 minutes; SE = 10.05; p= 0.279; MARA+SMS Difference T1-T0 = -11.5 minutes; SE = 8.80; p= 0.869; Control Difference T1-T0 = 10.9 minutes; SE = 9.07; p = 0.407). There was a higher participation in the MARA group in relation to the MARA+SMS group (MARA group = 34.4%; MARA+SMS group = 12.1%). There were no significant changes in adiposity at 10 weeks according to difference-in-differences analysis (body mass index p: ΔMARA+SMS group versus Δcontrol group = 0.945, ΔMARA group versus Δcontrol group = 0.847, ΔMARA+SMS group versus ΔMARA group = 0.990; FP p ΔMARA+SMS group versus Δcontrol group = 0.788, ΔMARA group versus Δcontrol group = 0.915, ΔMARA+SMS group versus ΔMARA group = 0.975).

Conclusion: The Active Module of Active Recess is a promising strategy to increase physical activity levels and decrease sedentary behavior in students. The addition of Text Messages was not associated with increased moderate to vigorous physical activity or changes in adiposity.

Study Design: Randomized community trial

Setting: Primary Schools in Bogota, Columbia

Population of Focus: 5th grade students

Data Source: Accelerometers, anthropometrics

Sample Size: 120 students from 3 randomly selected schools that were part of a larger study: International Study of Childhood Obesity, Lifestyles, and the Environment (ISCOLE)

Age Range: Ages 9-11

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Active Recess

Intervention Description: The active play intervention consisted of a 1-h outdoor physical activity session per week, incorporating 30 min of facilitated games and 30 min of free play.

Intervention Results: Sixty-six percent of eligible children (n = 137) agreed to participate in the research. No schools withdrew from the study and three participants were lost to follow-up. Compliance to the intervention was high-none of the participants missed more than two of the ten scheduled active play sessions. Data lost to follow-up were minimal; most were lost (14%) for school day physical activity. Active play sessions were shorter than planned on average by 10 min, and participants spent a mean of 39.4% (14.2) of the session time in moderate-to-vigorous intensity physical activity (MVPA). There was preliminary evidence of a small intervention effect on MVPA (d = 0.3), FMS score (d = 0.4), inhibition (fish trial: d = 0.1, arrow trial d = 0.1) and maths fluency (addition: d = 0.3, subtraction: d = 0.1).

Conclusion: The active play intervention was feasible and benefitted from a relatively high MVPA content; however, preliminary findings suggest the intervention had a small effect on the outcomes. Having more active play sessions per week and/or extending the duration of the intervention may increase the effects and these should be tested before a future definitive cluster RCT is undertaken.

Study Design: Feasibility cluster RCT

Setting: Primary schools in Glasgow, Scotland with at least 70% of pupils living in 20% most deprived areas of Scotland

Population of Focus: Year Primary 3 school children

Data Source: Accelerometer, Test of Gross Motor Development-2, NIH toolbox Flanker Test, One Minute Basic Number Facts Test

Sample Size: 8 classes, 207 students

Age Range: Age 7

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL Active Recess

Intervention Description: For schools to consider physical activity (PA) interventions, improvements must be shown in PA and additional educational benefits such as executive function (EF) and academic performance (AP). Over 8800 schools worldwide have implemented The Daily Mile™ (TDM), without any formal assessments of its impact. Rigorous and high-quality studies are needed to explore TDM’s contribution to moderate-to-vigorous PA (MVPA) guidelines and potential impact on EFs and AP.

Intervention Results: Using multi-level modelling, TDM revealed significantly greater MVPA (+10.23 min) and reduced sedentary time (−9.28 min) compared to control (p ≤ 0.001, d = 4.92, 3.61 retrospectively). Maths fluency interacted with condition and time (p = 0.031, d = 0.25); post hocs revealed no significances over time (p > 0.05). No differences in EFs (all p > 0.05).

Conclusion: This study is the first assessing the acute effects of TDM compared to continued academic lessons. TDM revealed no significant improvements in maths fluency or EF. These findings question justifying the widespread adoption of TDM based on enhanced cognition claims. Nonetheless, TDM may provide 10 min of MVPA, achieving a third of the daily in school recommendations to meet overall daily recommendations.

Study Design: RCT using a betweensubjects design

Setting: 14 classes in 11 primary schools

Population of Focus: Primary school-aged children

Data Source: Accelerometers; math fluency test and Executive function test

Sample Size: 303 children

Age Range: Mean age 8.99

Intervention Components (click on component to see a list of all articles that use that intervention): Active Recess PE Enhancements CLASSROOM_SCHOOL

Intervention Description: The purpose of this study was to investigate the effects of schoolyard renovations and a physical activity (PA) recess curriculum alone and in combination on children's PA.

Intervention Results: No meaningful intervention effects were found. Lack of an effect may be due to the brief dose of recess, the curriculum not being integrated within the schoolyard, the LL implementation occurring prior to the study, or the already high levels of PA.

Conclusion: Potential avenues to promote PA include making recess longer, integrating recess into the school curricula, and developing recess PA curricula integrating schoolyards.

Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Curricular Activities/Training Active Recess CLASSROOM_SCHOOL

Intervention Description: The purpose of this study was to investigate the effect of a 10-month, cluster-randomized controlled trial on physical activity level and aerobic fitness conducted in the city of Stavanger, Norway, in 2014-15.

Intervention Results: Intervention effects were found for time in moderate to vigorous physical activity (MVPA) (adjusted mean difference of 8 min/day, 95% CI: 3.4-13, p < 0.001) and total physical activity (60 counts/min, 95% CI: 15-105, p = 0.009). Children with low aerobic fitness increased their running distance compared to controls (d = 0.46; p = 0.001). During physically active academic lessons children spent 26% of the time in MVPA, which was comparable to physical education lessons.

Conclusion: The Active School program successfully increased physical activity for the intervention group and aerobic fitness for the least fit children. The activity level during physically active academic lessons was as high as in physical education lessons.