Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program, CLASSROOM_SCHOOL, Multicomponent School-Based Program

Intervention Description: The 12 month intervention encouraged healthy eating and physical activity, including a daily additional 30 minute school time physical activity opportunity, a six week interactive skill based programme in conjunction with Aston Villa football club, signposting of local family physical activity opportunities through mail-outs every six months, and termly school led family workshops on healthy cooking skills.

Intervention Results: Data for primary outcome analyses were: baseline, 54 schools: 1392 pupils (732 controls); first follow-up (15 months post-baseline), 53 schools: 1249 pupils (675 controls); second follow-up (30 months post-baseline), 53 schools: 1145 pupils (621 controls). The mean BMI z score was non-significantly lower in the intervention arm compared with the control arm at 15 months (mean difference -0.075 (95% confidence interval -0.183 to 0.033, P=0.18) in the baseline adjusted models. At 30 months the mean difference was -0.027 (-0.137 to 0.083, P=0.63). There was no statistically significant difference between groups for other anthropometric, dietary, physical activity, or psychological measurements (including assessment of harm).

Conclusion: The primary analyses suggest that this experiential focused intervention had no statistically significant effect on BMI z score or on preventing childhood obesity. Schools are unlikely to impact on the childhood obesity epidemic by incorporating such interventions without wider support across multiple sectors and environments.

Study Design: Cluster RCT

Setting: 53 schools

Population of Focus: Ages 5-6

Data Source: Actiheart worn continuously for 5 days

Sample Size: 1467 children

Age Range: Ages 5-6

Intervention Components (click on component to see a list of all articles that use that intervention): Extra-Curricular Activities, Comprehensive School-Based PA Program, CLASSROOM_SCHOOL, Multicomponent School-Based Program

Intervention Description: This research incorporated data from a subsample of after-school care enrollees above the 90th BMI percentile (Mage=10.1 years) who participated in either 4-day/week (n = 21) or 3-day/week (n = 24) versions of a 45 min/session, cognitive-behaviorally based physical activity/health behavior-change program over a full school year, or a control condition of usual care (n = 14).

Intervention Results: For the cognitive-behavioral groups only, significant improvements were found in self-regulation, mood, and physical activity. Their BMI increases of 0.12 and 0.11 kg/m2, respectively, were significantly less than the 0.90 kg/m2 rise expected through maturation. Theory-based regression models uniformly confirmed significant associations of changes in self-regulation and physical activity (R2s = .22–.25). However, within separate analyses, entry of changes in (a) self-efficacy and mood into a multiple regression equation, (b) self-efficacy as a mediator, and (c) mood as a moderator, did not increase predictive accuracies. The significant association of changes in physical activity and BMI was stronger in the heavier children. Findings will be useful for large-scale intervention applications and refinements.

Conclusion: Even given the stated limitations, the present research advanced the development of palatable behavioral treatments for young children with overweight and obesity. Theory and related research were also progressed through decomposing effects associated with Physical Activity and BMI Change in after-School Care 7 psychological changes over a full school year. Although challenging internal validity, the study’s field setting advantageously facilitated generalization of findings to community-based settings capable of helping large numbers of children in need (Green et al., 2013). Based on the present findings, it is hoped that practitioners consider the importance of facilitating behavioral (i.e., self-management) skills to enable even children of high weights to feel successful at physical activity pursuits. Additionally, factors such as the mood-enhancing effects of physical activity and the value of building feelings of ability (i.e., self-efficacy) should be considered in their program development. It is hoped that continued related research is able to affect large-scale change applied to the increasing problem of high weight in children.

Study Design: Multi-level research design

Setting: After-school program sites managed by a communitybased organization

Population of Focus: Elementary school aged children

Data Source: Student self-report and study staff physical assessments

Sample Size: 190 students

Age Range: Ages 8-11

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program, CLASSROOM_SCHOOL, Multicomponent School-Based Program

Intervention Description: This study aimed to assess the impact of a 7-month, intensive, city-wide intervention ("Life of Health") on tackling youth inactivity and sedentary behavior in an entire Latin-American city (Jaguariuna, Brazil). For youth, a program focused on tackling inactivity/sedentary behavior was delivered at every school (n = 18). Plausibility assessments (pre-to-post design) were performed with 3,592 youth (out of 8,300 individuals at school age in the city) to test the effectiveness of the intervention. Primary outcomes were physical activity and sedentary behavior. Secondary outcome was BMI z-score.

Intervention Results: Physical activity did not change (0; 95%CI:-2.7-2.8 min/day; p = 0.976), although physically inactive sub-group increased physical activity levels (11.2; 95%CI:8.8-13.6 min/day; p < 0.001). Weekday television and videogame time decreased, whereas computer time increased. Participants with overweight and obesity decreased BMI z-score (-0.08; 95%CI:-0.11-0.05; p < 0.001; -0.15; 95%CI:-0.19-0.11; p < 0.001). This intervention was not able to change the proportion of physical inactivity and sedentary behavior in youth at a city level. Nonetheless, physically inactive individuals increased PA levels and participants with overweight and obesity experienced a reduction in BMI z-score, evidencing the relevance of the intervention.

Conclusion: Education-based lifestyle programs should be supplemented with environmental changes to better tackle inactivity/sedentary behavior in the real-world.

Study Design: Quasi-experimental design

Setting: Schools in an entire Latin American city (teacher-led)

Population of Focus: Children and adolescents

Data Source: Student self-report

Sample Size: 3, 592 students

Age Range: Ages 6-17

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Teacher/Staff Training, Comprehensive School-Based PA Program

Intervention Description: The four-month intervention included strategies focused on training teachers, new opportunities for physical activity in the school environment, and health education strategies for the school community (including parents). Moderate- to-vigorous physical activity level (≥420 min/week), TV watching and computer use/gaming (<2 h/day), daily consumption of fruit juice, fruit, vegetables, soft drinks, savory foods and sweets, and current alcohol and tobacco use were measured before and after intervention.

Intervention Results: McNemar's test and logistic regression (odds ratio [OR] and a 95% confidence interval [95% CI]) were used, considering p < 0.05. In the intervention schools, a significant increase occurred in the number of adolescents who met physical activity guidelines (5.3%; 95% CI = 0.8; 9.8) and who reported using computer for <2 h a day (8.6%; 95% CI = 3.8; 13.4) after intervention. No changes were observed in the control schools. At the end of the intervention, adolescents from intervention schools were more likely to practice physical activity at recommended levels (OR = 1.44; 95% CI = 1.00; 2.08) than adolescents from control schools. No significant change was observed for the other lifestyle factors.

Conclusion: In conclusion, this multicomponent intervention was effective in promoting physical activity among adolescents from vulnerable areas. However, other lifestyle factors showed no significant change after intervention.

Study Design: Cluster RCT

Setting: 6 schools in the public education system

Population of Focus: Adolescents in grades 7-9

Data Source: Physical activity list and Youth Risk Behavior Survey Questionnaire

Sample Size: 548 adolescents in intervention group; 537 in the control group

Age Range: Ages 11-18

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program, CLASSROOM_SCHOOL

Intervention Description: The Healthy Primary School of the Future', is implemented with the aim of improving physical activity and dietary behaviour. For this intervention, pupils are offered an extended curriculum, including a healthy lunch, more physical exercises, and social and educational activities, next to the regular school curriculum.

Intervention Results: Mixed-model analyses showed significant favourable effects for the full HPSF versus control schools for, among others, school water consumption (effect size (ES) = 1.03 (T1), 1.14 (T2)), lunch intake of vegetables (odds ratio (OR) = 3.17 (T1), 4.39 (T2)) and dairy products (OR = 4.43 (T1), 4.52 (T2)), sedentary time (ES = -0.23 (T2)) and light PA (ES = 0.22 (T2)). Almost no significant favourable effects were found for partial HPSF compared to control schools.

Conclusion: We conclude that the full HPSF is effective in promoting children's health behaviours at T1 and T2 compared with control schools. Focusing on both nutrition and PA components seems to be more effective in promoting healthy behaviours than focusing exclusively on PA.

Study Design: Quasi-experimental longitudinal study

Setting: 4 control and 4 intervention pilot schools in the ‘Healthy Primary School of the Future’ project in Parkstad region of the Netherlands

Population of Focus: Children aged 4-12 enrolled in HPSF project schools

Data Source: Accelerometers, questionnaires,

Sample Size: 2,326 students

Age Range: Ages 4-12

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program, CLASSROOM_SCHOOL

Intervention Description: This study evaluated a multi-component school-based intervention (Y-PATH: Youth-Physical Activity Towards Health), focused on halting the age-related decline in physical activity of youth in early adolescence. A cluster randomized controlled trial in 20 post primary schools (10 control, 10 intervention) was conducted. Data were collected from all 20 schools at baseline (2013), and 12 months (2014), and from 10 of these schools (5 intervention) at 24 months (2015). The setting was mixed gender post primary schools residing in the greater area of Dublin, Ireland. Principals from each school were asked to nominate one first year class group attending their school in September 2013 to participate in the study (N = 564). Intervention schools implemented the Y-PATH whole school intervention, comprising teacher component, parent component, and PE component; while control schools continued with usual care. The main outcome measure was accelerometer derived average minutes of daily moderate to vigorous physical activity (MVPA).

Intervention Results: Results of the multilevel regression analysis confirmed that there was a significant time intervention effect, and this was predominantly contributed by the difference between control and intervention groups within females.

Conclusion: Findings support the case for national dissemination of the Y-PATH intervention so that the knowledge learned can be translated to routine practice in schools.

Study Design: Cluster RCT

Setting: Greater Dublin area primary schools

Population of Focus: First year post primary students

Data Source: Accelerometer

Sample Size: 564 students

Age Range: Ages 12-13

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program,

Intervention Description: The intervention evaluated in the study described in the PDF file is a city-wide school-located influenza vaccination (SLIV) program called Shoo the Flu, which has delivered free influenza vaccinations to schools in Oakland, California since 2014 ,[object Object],. The intervention was delivered to children in all public and charter elementary schools in Oakland Unified School District (OUSD, the “intervention district”) and offered to all other charter and private pre-schools and elementary schools in Oakland ,[object Object],. From 2014 to 2017, Shoo the Flu vaccinated 7,502 – 10,106 students annually (22 – 28% of eligible students) in 102–138 schools ,[object Object],. Each influenza season, 23–24% of intervention participants reported KPNC health plan membership ,[object Object],. In 2014–15 and 2015–16, the intervention provided the live attenuated influenza vaccine (LAIV) to students. Students with LAIV contraindications were offered the trivalent inactivated injectable influenza vaccine (IIV3), as were staff and teachers. Because LAIV effectiveness in children was low in 2014–15 and 2015–16, the intervention offered IIV4 to all participants following the Advisory Committee on Immunization Practices’ recommendation to use IIV for all children

Intervention Results: The study described in the PDF file found that the city-wide school-located influenza vaccination (SLIV) program called Shoo the Flu was associated with higher influenza vaccination coverage, lower Oseltamivir prescriptions in school-aged children, and lower medically attended acute respiratory illness (MAARI) among people over 65 years, suggesting possible indirect effects of SLIV among older adults ,[object Object],. The proportion of KPNC members vaccinated for influenza by KPNC or the SLIV program was 8–11% higher in the intervention site than the comparison site during the intervention period ,[object Object],. Among school-aged children, SLIV was associated with lower Oseltamivir prescriptions per 1,000 but not with other outcomes ,[object Object],. SLIV was associated with lower MAARI per 1,000 in adults 65 + years ,[object Object],. However, the study is subject to several limitations, including its observational design, unmeasured confounding, differences in sociodemographic characteristics between the study population and the general and student populations in the study sites, rare outcomes, and incomplete individual vaccination information ,[object Object],.

Conclusion: The study described in the PDF file suggests that a city-wide school-located influenza vaccination (SLIV) program called Shoo the Flu was associated with higher influenza vaccination coverage, lower Oseltamivir prescriptions in school-aged children, and lower medically attended acute respiratory illness (MAARI) among people over 65 years, suggesting possible indirect effects of SLIV among older adults ,[object Object],. However, the study is subject to several limitations, including its observational design, unmeasured confounding, differences in sociodemographic characteristics between the study population and the general and student populations in the study sites, rare outcomes, and incomplete individual vaccination information ,[object Object],. Therefore, further research is needed to confirm these findings and to better understand the potential benefits and limitations of SLIV programs in reducing the burden of influenza in the community.

Study Design: The study described in the PDF file is a retrospective cohort study that evaluated the effectiveness of a city-wide school-located influenza vaccination (SLIV) program implemented in over 102 elementary schools in Oakland, California ,[object Object],. The study compared the influenza vaccination coverage and related health outcomes of Kaiser Permanente Northern California (KPNC) members residing in either the intervention or a multivariate-matched comparison site from September 2011 to August 2017 ,[object Object],. The study used a genetic multivariate matching algorithm to pair-match public elementary schools in the intervention district and each candidate comparison district using pre-intervention school-level characteristics ,[object Object],. The study also adjusted for available potential confounders with at least 5% prevalence in each analysis, including race, ethnicity, sex, mediCAL, subsidized KPNC health plan, and primary language spoken ,[object Object],.

Setting: The setting of the provided PDF file is focused on the evaluation of a city-wide school-located influenza vaccination (SLIV) program implemented in over 102 elementary schools in Oakland, California ,[object Object],. The study evaluates the effectiveness of this program in increasing vaccine coverage among schoolchildren and reducing influenza transmission community-wide ,[object Object],.

Population of Focus: The target audience for the information in the PDF file includes researchers, public health professionals, and policymakers interested in understanding the effectiveness of a city-wide school-located influenza vaccination (SLIV) program and its impact on influenza vaccination coverage and related health outcomes. Additionally, individuals interested in public health interventions, influenza vaccination strategies, and community-wide disease prevention may also find the information relevant.

Sample Size: The sample size of the study described in the PDF file varies depending on the specific analysis being conducted. The study conducted a retrospective cohort study among Kaiser Permanente Northern California (KPNC) members of all ages residing in either the intervention or a multivariate-matched comparison site from September 2011 - August 2017 ,[object Object],. The analyses included 175,628 to 269,266 individuals and 9,436,202 to 11,500,570 person-weeks of observations per calendar year from 2011 to 2017 ,[object Object],.

Age Range: The study included Kaiser Permanente Northern California (KPNC) members of all ages residing in either the intervention or a multivariate-matched comparison site from September 2011 to August 2017 ,[object Object],. The age groups considered in the analysis were stratified as 0–4, 5–12, 13–17, 18–64, and 65+ years ,[object Object],. This indicates that the study encompassed a wide age range, from young children to older adults.

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program, Electronic PA, Assessment (patient/consumer),

Intervention Description: Participants in the BOXVR group engaged in exercise with a virtual reality game, while participants in the guided video group engaged in exercise with a guided workout video. Both interventions consisted of 5 exercise sessions per week, for a total of 15 exercise sessions over a 3-week period. Each exercise session was 10 minutes in length

Intervention Results: The BOXVR group showed a significant improvement in stress levels and performance on a cognitive task (TMT B) compared to the control and guided video groups. Adolescents who participated in BOXVR reported significantly higher levels of enjoyment than those who participated in traditional boxing with a guided video. The control group was the only group that showed a significant reduction in anxiety, but this could be interpreted as possible changes in behavior simply due to being enrolled in a research study and asked about anxiety status. The study suggests that engagement and enjoyment in a 'play' setting may contribute to mental aspects of health in the short-term more than the level of effort

Conclusion: The study suggests that chronic exercise with a VR game may be an effective tool for reducing stress and improving cognitive performance in adolescents. The findings also highlight the importance of engagement and enjoyment in exercise programs for mental health benefits. Future studies should investigate what aspects of gaming in VR contribute the most to stress reduction and cognitive performance

Study Design: The study design is a Pilot Randomized Controlled Trial

Setting: The setting for the study was a public high school in suburban New York, and the study was conducted during the summer of 2021

Population of Focus: The target audience for the study was healthy high school students between the ages of 14 and 18 who were able to participate in physical activity of at least moderate intensity

Sample Size: The sample size for the study was 42 participants, who were randomized into one of three cohorts: a BOXVR group, a guided video group, or a nonintervention control group

Age Range: The age range of the participants was between 14 and 18 years old

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Comprehensive School-Based PA Program, Presentation/meeting/information Session (Classroom), Physically Active Classrooms, Multicomponent School-Based Program

Intervention Description: “GiochiAmo” is an innovative randomized field trial which aims to educate children aged about nutrition, physical activity, smoking and alcohol. Each primary school class worked on a different theme. Particularly, the project is structured in two sequential phases: a lesson for each theme followed by several game sessions during the next three months.

Intervention Results: A total number of 74 and 76 children participated in the physical activity and nutrition interventions. NTs was 4.17 (SD: 2.23) before and 5.03 (SD: 2.79) after the intervention (P = 0.005). PAs was 27.4 (SD: 9.6) before and 30.5 (SD: 10.7) after the intervention (P = 0.003). No significant differences were obtained comparing males and females for all scores. Ds was 0.86 for nutrition and 3.1 for physical activity. Univariate analysis of Delta scores obtained no significant differences.

Conclusion: The present results confirm the effectiveness of 'GiochiAMO' to change nutrition and physical activity behavior.

Study Design: Single arm, cluster field trial (c-RCT)

Setting: Public primary schools

Population of Focus: Second and third grade students in primary school

Data Source: Student self-report

Sample Size: 150 students

Age Range: Ages 6-9

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program, CLASSROOM_SCHOOL, Multicomponent School-Based Program

Intervention Description: The Shaping Healthy Choices Program is a multi-component, school- based intervention that was developed to improve children’s health. This program integrates activities within four components, all working together to sustain positive health outcomes: Nutrition education and promotion, Family and community partnerships, Foods available on the school campus with an emphasis on regional agriculture, School wellness policies

Intervention Results: Mean minutes of MVPA significantly increased at the intervention school (22.3 + 37.8; p = 0.01) and at the control school (29.1 + 49.5; p = 0.01). There were no significant differences in the change in MVPA between the schools. Youth at the intervention school significantly decreased mean minutes in sedentary activity compared to the controls (p = 0.02).

Conclusion: Youth who participated in the SHCP decreased time spent in sedentary activity and increased very vigorous physical activity from pre- to post-intervention, while these changes were not observed at the control school. The overall small physical activity intensity pattern shift supports that physical activity is an important area to target within a multicomponent nutrition intervention aimed at preventing childhood obesity.

Study Design: Pre and post assessments at intervention and control schools

Setting: 2 schools (one intervention and 1 control)

Population of Focus: 4th graders

Data Source: Accelerometer (Polar Active monitors)

Sample Size: 92 youth

Age Range: Ages 9.5-9.6

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Comprehensive School-Based PA Program

Intervention Description: In this study, we examined the development of children's moderate to vigorous physical activity (MVPA) and physical education (PE) enjoyment through the Physical Activity as Civil Skill Program 2012-2014.

Intervention Results: The proportion of children meeting the current MVPA guidelines declined from 38% to 22% (intervention) and 14% to 9% (control), whereas PE enjoyment was stable in both groups. Boys were more physically active than girls only within control group children. Teachers' feedback indicated that violence and bullying among intervention students reduced during the program, which can be considered as an additional benefit.

Conclusion: It may be that both MVPA and PE enjoyment may require more tailored actions to be increased across a long-term program. It is important to ensure that school-based physical activity programs, especially including transition from elementary to middle school level, provide all children positive experiences, and thus, may improve their motivation, and MVPA participation during school days and leisure time.

Study Design: RCT (Voluntary participation as control/ intervention schools; collected data from random subset)

Setting: Elementary schools in central and northeast Finland

Population of Focus: Elementary school students

Data Source: Accelerometer, online questionnaire

Sample Size: 661 students

Age Range: Ages 11-13

Intervention Components (click on component to see a list of all articles that use that intervention): Multicomponent School-Based Program, Comprehensive School-Based PA Program, CLASSROOM_SCHOOL

Intervention Description: In this study, we examined the development of children's moderate to vigorous physical activity (MVPA) and physical education (PE) enjoyment through the Physical Activity as Civil Skill Program 2012-2014.

Intervention Results: The proportion of children meeting the current MVPA guidelines declined from 38% to 22% (intervention) and 14% to 9% (control), whereas PE enjoyment was stable in both groups. Boys were more physically active than girls only within control group children. Teachers' feedback indicated that violence and bullying among intervention students reduced during the program, which can be considered as an additional benefit.

Conclusion: It may be that both MVPA and PE enjoyment may require more tailored actions to be increased across a long-term program. It is important to ensure that school-based physical activity programs, especially including transition from elementary to middle school level, provide all children positive experiences, and thus, may improve their motivation, and MVPA participation during school days and leisure time.

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Comprehensive School-Based PA Program

Intervention Description: PA levels from 3294 fourth grade students in 24 intervention schools and 7 control schools in metropolitan Atlanta, Georgia were measured during the 2015-2016 academic year. PA measures included daily steps in school, steps taken in physical education class (PE), and percent of PE class time spent in moderate-to-vigorous physical activity (MVPA). Intervention effectiveness was assessed using generalized estimating equations adjusting for sex and school-level socioeconomic status (SES).

Intervention Results: After adjusting for sex and school-level SES, intervention students had significantly higher increases in average daily steps (p < .05), steps taken in PE (p < .01), and percent of PE class spent in MVPA (p < .01) than control students.

Conclusion: Our findings demonstrate the effectiveness of CSPAPs in increasing PA. Further research using randomized controlled trials of large-scale implementations, longer follow-up periods, and more diverse student sample is warranted.

Study Design: Quasi-experimental design

Setting: Georgia public elementary schools in 3 metropolitan Atlanta counties

Population of Focus: Elementary school aged children

Data Source: Pedometers, and Gopher FITstep Pros

Sample Size: n 3,294 students

Age Range: Ages 9-10

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Comprehensive School-Based PA Program

Intervention Description: We randomly allocated 2 clusters of 2 Catholic middle (grades 6-8) schools/cluster to a 2-week no treatment/4-week intervention crossover trial to determine the effects of a 20-day Lenten-themed PA intervention on 187 students' pedometer steps taken at school. Specifically, students independently progressed through a workbook (Savior's Sandals) that depicted and informed about 11 locations in the Holy Land where Jesus lived, visited, and/or ministered, and included Scripturally-based questions about each place for students to answer. In all, students would accumulate 110,000 steps if they completed the workbook virtual journey. General linear mixed models with restricted maximum likelihood estimation to compensate for missing data were used to compute the intervention effects on mean daily steps.

Intervention Results: There were significant main effects for the intervention overall and by school and grade level. Follow-up tests isolated that a single school (Meandiff = + 2156 steps/day) and grade 6 students (Meandiff = + 1678 steps/day) across all four schools experienced the greatest treatment effects.

Conclusion: Religious-themed PA interventions can be effective; however, specific adjustments may be needed to optimize the intervention's effectiveness for a broader population of students.

Study Design: Crossover controlled design

Setting: Catholic middle schools (teacher-led)

Population of Focus: Catholic middle school aged children grades 6-8

Data Source: Student self-report and pedometer data

Sample Size: 187 students

Age Range: Ages 11-13

Intervention Components (click on component to see a list of all articles that use that intervention): Educational Material, Comprehensive School-Based PA Program,

Intervention Description: - Intervention description: The intervention included onsite school-based HPV vaccination events, community-based education, and distribution of educational materials. The comparison schools received community-based education only.

Intervention Results: - Results: The study found that the intervention school had a lower baseline HPV vaccine initiation and completion rate than the comparison schools. However, the initiation and completion rates increased significantly at the intervention school after the implementation of the school-based vaccination events and community-based education. The proportion of students who were vaccinated onsite at the intervention school was 30.8%.

Conclusion: - Conclusion: The study concludes that school-based HPV vaccination events and community-based education can significantly increase HPV vaccine uptake in underserved areas.

Study Design: - Study design: The study used a quasi-experimental design with an intervention school (onsite vaccination events and community-based education) and two comparison schools (community-based education only).

Setting: - Setting: The study was conducted in the Rio Grande City Consolidated Independent School District (RGCCISD) in Texas, which is an underserved area with a predominantly Hispanic population.

Population of Focus: - Target audience: The target audience was 6th-, 7th-, and 8th-grade students in the intervention and comparison schools.

Sample Size: - Sample size: The total enrollment of 6th-, 7th-, and 8th-grade students at the intervention school was n = 885, and n = 1422 at the comparison schools.

Age Range: - Age range: The mean age of students at the intervention school was 12.23 years ± 0.90, range = 9.9–14.4, and at the comparison schools was 12.18 years ± 0.91, range = 9.94–14.22.

Intervention Components (click on component to see a list of all articles that use that intervention): Comprehensive School-Based PA Program,

Intervention Description: City-wide school-located influenza vaccination program

Intervention Results: The vaccination coverage was higher in the intervention district compared to the comparison district, with larger differences observed among White and Hispanic/Latino students. The program was effective in reducing influenza-related hospitalizations among students in the intervention district, with the largest reduction observed among Hispanic/Latino students.

Conclusion: The city-wide school-located influenza vaccination program was effective in increasing vaccination coverage and reducing influenza-related hospitalizations among students, with larger benefits observed among certain racial/ethnic groups.

Study Design: Matched cohort study

Setting: Oakland, California

Population of Focus: Students in participating schools

Sample Size: 16,347 students

Age Range: Kindergarten to 12th grade

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Comprehensive School-Based PA Program

Intervention Description: The core intervention component was physically active academic lessons, a teaching activity that combines physical activity and educational content. 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. The physical activity level during physically active academic lessons was also studied. A total of 447 children (9-10 years) participated. The weekly intervention consisted of physically active academic lessons, physically active homework and physically active recess.

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.

Study Design: Cluster RCT

Setting: All schools in a municipality in Norway

Population of Focus: Primary school students

Data Source: Accelerometer; interval test

Sample Size: 447 students

Age Range: Ages 9-10

Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Comprehensive School-Based PA Program

Intervention Description: A mixed factorial two (group) × two (time) wait-list controlled trial was conducted and reported using the TREND guidelines. A total of 155 children (56% females; intervention n = 84, control n = 71) took part and completed measures at baseline (week 0) and post-intervention (week 11). The effect of the intervention on MVPA (model 1) and well-being (model 2) was tested through serial mediation models with three mediators (i.e. autonomy-support, needs satisfaction and intrinsic motivation).

Intervention Results: In comparison to the control group, the intervention was related to increases in MVPA (β = .45) and autonomy-support (β = .17). In model 1, analyses revealed partial mediation of the MVPA change through autonomy-support (β = .14), intrinsic motivation (β = .51) and all three SDT mediators in sequence (total r 2 = .34). In model 2, well-being was indirectly enhanced through autonomy-support (β = .38) and autonomy-support and needs satisfaction in sequence (total r 2 = .21).

Conclusion: The HCP enhanced MVPA and well-being by engendering a needs-supportive physical activity environment. The scientific and practical contribution of this study was the application of SDT in all aspects of the HCP intervention's design and analyses. Practitioners may consider integrating SDT principles, as implemented in the HCP, for health promotion.

Study Design: 2 group, 2 time points RCT

Setting: 2 schools in Northern Ireland

Population of Focus: 8-9-year-old students with low SES

Data Source: Accelerometers, questionnaires

Sample Size: 155 students

Age Range: Ages 8-9

Intervention Components (click on component to see a list of all articles that use that intervention): School-Based Family Intervention, Peer-led Mentoring/Support Counseling, Comprehensive School-Based PA Program,

Intervention Description: The intervention involved embedding whole-school and classroom-level prevention/promotion programs alongside small group and individual services for selected youth.

Intervention Results: Students participating in early intervention had significantly improved social-emotional competencies and coping skills (particularly those students at highest risk), and students with mental health disorders who participated in clinical treatment had significantly improved symptoms and functioning. Schools significantly enhanced their capacity to provide mental health services across prevention/promotion, early identification/intervention, and crisis management domains. These findings were replicated across 3 consecutive years of program implementation.

Conclusion: A school-hospital partnership using an MTSS model was found to be feasible, valued, and effective in improving students' mental health status and schools' capacities to provide mental health services.

Study Design: The study utilized a school-hospital partnership to implement a multitiered system of support (MTSS) model over 3 consecutive academic years.

Setting: The study was conducted in 6 urban public schools.

Population of Focus: The target audience for the study was elementary through high-school students enrolled in the 6 urban public schools.

Sample Size: 2700 students

Age Range: The schools included high (52% of total students), middle (21%), and elementary (27%) level classrooms.