Find Established Evidence

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): YOUTH, Adult-led Support/Counseling/Remediation
Intervention Description: The main aim of this study was to analyze whether adolescents attending a PA consultation in a clinical setting show more therapeutic success at 6 months, based on body mass index (BMI) z-score and waist circumference (WC), compared to those only followed by the pediatrician and nutritionist.
Conclusion: Although the success of adolescent obesity management cannot be based only on BMI, a PA consultation on the top of the traditional pediatric and nutrition interventions may further improve the BMI z-score outcome at 6 months.

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): COMMUNITY, Other (Communities)
Intervention Description: The objective of this review was to identify, evaluate, and synthesize the findings on built-environment determinants and their relation to participation in different domains of activities, including physical activity, recreational and social activities, and well-being in childhood and adolescence.
Conclusion: The following determinants potentially support active travel behavior: less traffic exposure and more safety features, pedestrian infrastructure for walking and cycling, shorter distances to facilities and greater walkability. A high facility and amenity index might promote unspecified physical activity. Policies and planning processes should consider these determinants to strengthen children's and adolescents' health and well-being. However, there are remaining research gaps and important avenues for future research that need to be addressed before more specific and robust conclusions can be drawn.

NPM: 8: Physical Activity
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.
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
Target Audience: Ages 5-6
Data Source: Actiheart worn continuously for 5 days
Sample Size: 1467 children
Age Range: Ages 5-6

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): Extra-Curricular Activities, CLASSROOM_SCHOOL
Intervention Description: an intervention that provides children and their parent more time to interact positively could impact children's PA. We examined the efficacy of a 12-week mother-daughter intervention on African-American girls' PA levels. In Spring of 2013 and 2014, mother-daughter dyads (n = 76) from Springfield, MA, were randomly assigned to one of three groups [child-mother (CH-M, n = 28), child alone (CH, n = 25), or control (CON, n = 23)] that participated in an afterschool culturally-tailored dance intervention (60 min/day, 3 days/week, 12 weeks). Girls in the CH-M group participated in the intervention with their maternal figure, while girls in the CH group participated in the intervention alone. CON group participants received weekly health-related newsletters.
Conclusion: This culturally-tailored mother-daughter afterschool intervention influenced African-American girls' afterschool hour PA levels, but not total daily PA.
Study Design: Random assignment to one of 3 groups; comparison of change
Setting: After-school dance intervention
Target Audience: African American girls ages 7-10
Data Source: Accelerometers
Sample Size: 76 mother-daughter dyads
Age Range: Ages 7-10

NPM: 8: Physical Activity
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).
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
Target Audience: Elementary school aged children
Data Source: Student self-report and study staff physical assessments
Sample Size: 190 students
Age Range: Ages 8-11

NPM: 8: Physical Activity
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.
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)
Target Audience: Children and adolescents
Data Source: Student self-report
Sample Size: 3, 592 students
Age Range: Ages 6-17

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): Electronic PA, PARENT_FAMILY
Intervention Description: Exergame use (or active video games that promote physical activity (PA)) has the potential to increase PA in youth, but there is a scarcity of information about PA of youth who are current exergamers. The current study examined PA behaviors in exergamers versus non-exergamers.
Conclusion: PA behavior in exergamers is similar to PA behavior in non-exergamers. However, when targeting vigorous PA, exergaming may be an innovative and appealing intervention strategy for adolescent girls.
Study Design: Cross-sectional
Setting: Public high schools in Minneapolis/St. Paul Minnesota metropolitan area
Target Audience: Students in Eating and Activity in Teens (EAT 2010) study
Data Source: Questionnaires
Sample Size: 2,793 students
Age Range: Ages 12-17

NPM: 8: Physical Activity
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.
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
Target Audience: Children aged 4-12 enrolled in HPSF project schools
Data Source: Accelerometers, questionnaires,
Sample Size: 2,326 students
Age Range: Ages 4-12

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): Physically Active Classrooms, CLASSROOM_SCHOOL
Intervention Description: Given the need to find more opportunities for physical activity within the elementary school day, this study was designed to asses the impact of I-CAN!, active lessons on: 1) student physical activity (PA) outcomes via accelerometry; and 2) socioeconomic status (SES), race, sex, body mass index (BMI), or fitness as moderators of this impact.
Conclusion: Active learning increases PA within elementary students, and does so consistently across demographic sub-groups. This is important as these sub-groups represent harder to reach populations for PA interventions. While these lessons may not be enough to help children reach daily recommendations of PA, they can supplement other opportunities for PA. This speaks to the potential of schools to adopt policy change to require active learning.
Study Design: Multilevel regression model
Setting: 28 central Texas elementary schools
Target Audience: Fourth grade students across different schools in Texas
Data Source: Accelerometer
Sample Size: 2,493 students
Age Range: Ages 9-10 (4th grade)

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): Adult-led Curricular Activities/Training, Physically Active Classrooms, CLASSROOM_SCHOOL
Intervention Description: Nine third- through sixth-grade classrooms (n = 292 students) in one elementary-middle school in Detroit, Michigan (49% female, 95% nonwhite; 80% qualified for free/reduced lunch) participated in this 20-week intervention where teachers implemented 5 × 4 min moderate-to-vigorous activity breaks per day. Gamification of activity breaks occurred during weeks 13-20 of the intervention and included the use of game design elements and classroom goals for activity break intensity. Moderate-to-vigorous physical activity (MVPA) during activity breaks was measured via direct observation.
Conclusion: These findings provide preliminary evidence that gamifying activity breaks may be an important strategy for increasing student participation in classroom activity breaks.
Study Design: Cohort design
Setting: One elementary-middle school in Detroit, MI, where at least 40% of students qualified for free/reduced priced lunch
Target Audience: Students who were able to participate in physical education classes from 9 3rd through 6th grade classrooms
Data Source: System for Observing Play and Leisure Activity in Youth (SOPLAY)
Sample Size: 292 students
Age Range: Ages 8-13

NPM: 8: Physical Activity
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).
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
Target Audience: First year post primary students
Data Source: Accelerometer
Sample Size: 564 students
Age Range: Ages 12-13

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): Training (Parent/Family), Extra-Curricular Activities, PARENT_FAMILY, CLASSROOM_SCHOOL, Family-Based Interventions
Intervention Description: This was an 11-week, two group, randomized feasibility study. Participants were children and their parents at one OOSP on a rural American Indian reservation. Children, ages 6–9, were randomized to receive the Generations Health (GH) intervention or comparison condition. The GH group received daily activities focused on physical activity (PA), nutrition, sleep, and reducing TV/screen time, and frequently engaged parents. The comparison group received usual OOSP activities. To assess intervention feasibility, we measured recruitment and participation rates and program satisfaction. We assessed pre- to posttest changes in body composition, PA and sleep patterns, dietary intake and Healthy Eating Index-2010 (HEI-2010) scores, TV/screen time, and nutrition knowledge. We report recruitment and participation rates as percentages and participants’ program satisfaction as means. Two-tailed paired t tests and 95% confidence intervals were used to detect changes in behavioral and health outcome variables.
Conclusion: High recruitment, participation and program satisfaction and positive health and behavioral outcomes at 11 weeks provide encouraging indications of the feasibility and potential effectiveness of the intervention.
Study Design: Feasibility RCT
Setting: American Indian Reservation
Target Audience: Rural students
Data Source: Activity monitors (PA levels), questionnaire (sedentary/screen activity)
Sample Size: 24 students
Age Range: Ages 6-9

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Physically Active Classrooms
Intervention Description: The intervention was performed in a sample of 47 children attending a primary school in the south of Italy and it was structured in two sessions of classroom active breaks (CABs) in three school days a week, shared with and supervised by the teachers.
Conclusion: CABs program is a safe tool to reduce inactivity and increase moderate/vigorous PA. Designing structured exercise breaks adapted in a flexible way to meet the needs of the school curriculum program may increase the feasibility of such PA program in the schools.
Study Design: Non-randomized feasibility study
Setting: Elementary schools (teacher-led)
Target Audience: 3rd grade school children
Data Source: Accelerometer data and student self-report
Sample Size: 47 students
Age Range: Ages 8-9

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Adult-led Curricular Activities/Training, Physically Active Classrooms
Intervention Description: Teachers at 5 elementary schools attended training on how to implement CBPA. Data on school-day PA opportunities [physical education (PE), recess, and CBPA] were obtained via calendar and teacher-recorded CBPA logs. Daily step counts were measured via accelerometry in 1346 students across 65 classrooms in first through fifth grades.
Conclusion: Gender disparities in step totals were present on PE and recess days, but not on CBPA days. CBPA appears to provide equal PA benefits for both genders and to potentially minimize the decline in PA among older students.
Study Design: Quasi-experimental design
Setting: Public elementary schools (teacher-led)
Target Audience: 1st through 5th grade school children
Data Source: Accelerometer data and teacher self-report
Sample Size: 1,346 students
Age Range: Ages 6-11

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Peer-led Curricular Activities/Training, Extra-Curricular Activities
Intervention Description: Female participants, aged 11-13 years, were recruited from six post-primary schools in Northern Ireland. Participants were randomized by school (cluster) to participate in regular 10-15-min peer-led brisk walks throughout the school week (the WISH study) (n = 101, two schools) or to continue with their usual PA (n = 98, four schools). The primary outcome measure was school-time PA post intervention (week 12), assessed objectively using an Actigraph accelerometer. Secondary outcome measures included anthropometry, cardiorespiratory fitness and psychosocial measures. Changes in PA data between baseline (T0) and end of intervention (week 12) (T1) were analysed using a mixed between-within subjects analysis of variance with one between (group) and one within (time) subjects factor, with two levels.
Conclusion: The intervention increased daily light intensity PA behaviour in these adolescent girls but did not change moderate to vigorous physical activity (MVPA). These findings suggest that a school-based brisk walking intervention may be feasible and can change PA behaviour in the short term, but it is possible that the self-selected walking speeds determined by a peer-leader may not be sufficient to reach MVPA in this age group. Further research is needed to evaluate the potential of school-based brisk walking to contribute to MVPA in adolescent girls.
Study Design: Cluster RCT
Setting: 6 post-primary schools in Northern Ireland
Target Audience: Girls in participating schools without medical conditions that would limit their participation
Data Source: Accelerometers, BMI, Queens College Step Test (cardiovascular fitness), selfefficacy for PA questionnaire
Sample Size: 6 schools: 101 female students from 2 schools (intervention), 98 female students in 4 schools (control)
Age Range: Ages 11-13

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Physically Active Classrooms
Intervention Description: We conducted a quasi-experimental repeated measures pilot study in two primary schools in the Stirling Council area: one school with, and one without, intention to introduce the Daily Mile. Pupils at the control school followed their usual curriculum. Of the 504 children attending the schools, 391 children in primary classes 1-7 (age 4-12 years) at the baseline assessment took part. The follow-up assessment was in the same academic year. Outcomes were accelerometer-assessed average daily moderate to vigorous intensity physical activity (MVPA) and average daily sedentary behaviour, 20-m shuttle run fitness test performance and adiposity assessed by the sum of skinfolds at four sites. Valid data at both time points were collected for 118, 118, 357 and 327 children, respectively, for each outcome.
Conclusion: The findings show that in primary school children, the Daily Mile intervention is effective at increasing levels of MVPA, reducing sedentary time, increasing physical fitness and improving body composition. These findings have relevance for teachers, policymakers, public health practitioners, and health researchers.
Study Design: QE repeated measures pilot
Setting: 2 primary schools
Target Audience: Primary school children
Data Source: Accelerometer, bodycomposition
Sample Size: 391 students
Age Range: Ages 4-12

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, PE Enhancements
Intervention Description: This school-based feasibility study of a randomised cluster trial recruited adolescents aged 12-14 years (n = 224) from five schools (three intervention; two control) in Belfast, Northern Ireland. The 22-week intervention (The StepSmart Challenge) informed by self-determination theory and incorporating gamification strategies involved a school-based pedometer competition. Outcomes, measured at baseline, and post-intervention (at 22 weeks post-baseline and 52 weeks post-baseline) included daily minutes of moderate to vigorous physical activity (MVPA) (measured using ActiGraph accelerometer), mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale), social support for physical activity, time preference (for delayed and larger rewards or immediate and smaller rewards), pro-social behaviour (Strengths and Difficulties Questionnaire (SDQ)) and the influence of social networks. The intervention's acceptability was explored in focus groups.
Conclusion: The level of interest and high recruitment and retention rates provide support for the feasibility of this trial. The intervention, incorporating gamification strategies and the recruitment methods, using parental opt-out procedures, were acceptable to participants and teachers. Teachers also suggested that the implementation of The StepSmart Challenge could be embedded in a lifelong learning approach to health within the school curriculum. As young people's lives become more intertwined with technology, the use of innovative gamified interventions could be one approach to engage and motivate health behavioural change in this population.
Study Design: Feasibility study of a randomized cluster trial
Setting: 5 post-primary schools
Target Audience: Adolescents aged 12-14 years from 5 schools
Data Source: Accelerometers and questionnaires. Aggregate step counts from Fitbit Zip data were updated weekly for each team on the StepSmart Challenge website leader board
Sample Size: 224 students
Age Range: Ages 12-14

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, PE Enhancements
Intervention Description: We followed up 228 children who started school in 1998-2000 seven years later, when they had reached a mean age of 14.8. The 152 children (59% boys) at the intervention school did 200 minutes of physical education per week during that period, and the 76 children (50% boys) in the three control schools did the standard 60 minutes. Questionnaires assessed the durations of total and leisure-time physical activity and screen-time activity at baseline and after five and seven years.
Conclusion: A school-based exercise intervention programme increased the total duration of physical activity in both sexes without any compensatory increase in screen-time activity. The findings contradict the activity-stat theory, which stated that the duration of physical activity in children is constant.
Study Design: Comparative study (pre-post test) intervention vs. control schools
Setting: 4 primary schools
Target Audience: Primary school students
Data Source: Questionnaires assessed the durations of total and leisuretime physical activity and screen-time activity at baseline and after 5 and 7 years
Sample Size: 228 students
Age Range: Ages 6-9 at beginning of study; Ages 13-16 at end of study

NPM: 8: Physical Activity
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.
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
Target Audience: Second and third grade students in primary school
Data Source: Student self-report
Sample Size: 150 students
Age Range: Ages 6-9

NPM: 8: Physical Activity
Intervention Components (click on component to see a list of all articles that use that intervention): CLASSROOM_SCHOOL, Homework/Extra Credit, Presentation/meeting/information Session (Classroom), Adult-led Curricular Activities/Training
Intervention Description: A total of 675 children aged 7-10 years from 16 New Zealand primary schools participated in the Healthy Homework study. Schools were randomised into intervention and control groups (1:1 allocation). Intervention schools implemented an 8-week applied homework and in-class teaching module designed to increase physical activity and improve dietary patterns. Physical activity was the primary outcome measure, and was assessed using two sealed pedometers that monitored school- and home-based activity separately. Secondary outcome measures included screen-based sedentary time and selected dietary patterns assessed via parental proxy questionnaire. In addition, height, weight, and waist circumference were measured to obtain body mass index (BMI) and waist-to-height ratio (WHtR). All measurements were taken at baseline (T0), immediately post-intervention (T1), and 6-months post-intervention (T2). Changes in outcome measures over time were estimated using generalised linear mixed models (GLMMs) that adjusted for fixed (group, age, sex, group x time) and random (subjects nested within schools) effects. Intervention effects were also quantified using GLMMs adjusted for baseline values.
Conclusion: A compulsory health-related homework programme resulted in substantial and consistent increases in children's physical activity - particularly outside of school and on weekends - with limited effects on body size and fruit consumption. Overall, our findings support the integration of compulsory home-focused strategies for improving health behaviours into primary education curricula.
Study Design: Cluster RCT
Setting: Primary schools in Auckland or Dunedin
Target Audience: 3rd-5th year students
Data Source: Pedometers, questionnaires (diet, television and computer usage), anthropometrics
Sample Size: 675 students from 16 schools
Age Range: Ages 7-10