Physically active lessons in schools and their impact on physical activity, educational, health and cognition outcomes: a systematic review and meta-analysis

The links between experiential learning and 4E cognition

In this article, we explore the connections between two distinct approaches: experiential learning (EL) and 4E cognition. EL emphasizes the role of concrete experiences as the building blocks of learning, whereas 4E cognition views cognition as arising from the interactions that an individual has with their physical and social environment. Despite their divergent theoretical frameworks, methodologies, and interests, we argue that both frameworks share a common vision of cognition and that their integration could mutually enhance their respective fields. This article outlines the historical origins and underlying assumptions of both frameworks, highlighting the potential links that can be established between them. Specifically, we explore the significance of embodiment, embeddedness, extended cognition, and enactive processes in learning and cognition. To bridge these frameworks, we propose employing the concept of "concrete experience" as an active engagement of individuals with their physical and social surroundings. By encompassing the essential aspects assigned to concrete experiences in EL, as well as the embodiment, situatedness, extended cognition, and enactive features of 4E cognition, this notion serves as a unifying element. Ultimately, the article suggests that combining the insights from EL and 4E cognition can offer a richer, more holistic understanding of representation.

The Erasmus+ EUMOVE project-a school-based promotion of healthy lifestyles to prevent obesity in European children and adolescents

The aim of this study was to describe the goals, activities, and methods of EUMOVE project in developing a set of resources targeting both primary and secondary schools that allow the entire educational community to promote healthy lifestyles (HL). The EUMOVE project is an Erasmus+ program based in the Creating Active Schools (CAS) framework. The project lasted 3 years and was developed by 14 academic and non-governmental institutions from Spain, Portugal, France, Italy, and the UK. EUMOVE was divided into three phases. In the first phase, several work packages were carried out aimed to ensure the coordination/management of the project activities. In the second phase, seven educational resources strengthened by rigorous scientific research were developed to promote HL from schools. During the last phase, all the resources were disseminated through scientific seminars, workshops with families and teachers, and the online promotion by the non-governmental institutions of each country. The EUMOVE project developed and promoted a smartphone APP, video/activity repository of physically active lessons, active break virtual platform, learning units, and parent/teachers/school-leaders' guidelines to promote physical activity, active commuting, active school playgrounds, healthy diet, and sleep habits. To our knowledge, EUMOVE is the first European project to provide a set of practical tools based on scientific evidence to help schools or future school-wide interventions implement a paradigm shift based on the CAS framework for the promotion of HL. Future research will need to investigate the implementation, effectiveness, and scalability of this proposal.

Associations Between Substitution of Sedentary Behavior Patterns With Physical Activity and Cardiovascular Risk Factors in Adolescents: A 3-Year Longitudinal Study

BACKGROUND

Little is known on how the substitution of time spent in sedentary behavior (SB) patterns with time spent in physical activity impacts cardiovascular risk factors during adolescence. The study aimed to investigate how the substitution of time spent in SB and sedentary bouts with time spent in different physical activity intensities was associated with longitudinal changes in cardiovascular risk factors in analyses stratified by sex.

METHODS

This is a prospective cohort study with a mean follow-up period of 3.2 (±0.34) years, involving 109 (60 girls and 49 boys) Brazilian adolescents. Body mass index, waist circumference, and cardiorespiratory fitness were the cardiovascular risk factors considered. A cardiovascular risk score was calculated. Sedentary bouts, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) were measured by accelerometers. Multivariate linear regression models adopting the isotemporal substitution were used to analyze the association between substitution of 10 minutes per day of sedentary bouts with LPA and MVPA and risk factors. All analyses considered 5% significance levels.

RESULTS

Substitutions of SB, short and long bouts, with MVPA were associated with higher cardiorespiratory fitness in boys (β = 0.077; 95% confidence interval, 0.001 to 0.55; β = 0.076; 95% confidence interval, 0.003 to 0.154; and β = 0.084; 95% confidence interval, 0.001 to 0.167, respectively). No associations were observed when analyses involved substitution of sedentary bouts with LPA, adiposity, cardiovascular risk score, and girls.

CONCLUSIONS

Substituting SB bouts with MVPA appears to favorably influence changes of cardiorespiratory fitness in boys during adolescence. Greater benefits appear to occur when longer sedentary bouts are substituted by MVPA.

A Comprehensive Planning Framework for Designing Effective Physical Activity Interventions in Youth

BACKGROUND

Effective physical activity (PA) interventions are needed to counter the insufficient and declining levels of PA in youth. These require an updated, comprehensive planning framework that consolidates recent decades of progress in promoting PA in young children, children, and adolescents. Effective PA interventions require program planning and conceptual model development that target a coordinated and multilevel set of age-specific PA determinants. Accordingly, this paper presents a comprehensive planning framework that researchers can use to design intervention research to promote PA in youth.

METHODS

The first author conducted targeted searches through Google Scholar to compile PA models/frameworks/guides applicable to youth, a comprehensive set of PA determinants, and determinant-linked strategies to promote PA focusing on review articles. The information was summarized in tables, synthesized, and used to create a planning framework, all of which were reviewed by coauthors.

RESULTS

The APPLE Framework for Planning PA Opportunities for Youth (APPLE = Age, PA focus, Place and time, Leverage relevant influences and strategies, and ensure Enjoyable PA opportunities) incorporated all core elements from targeted reviews to create a comprehensive planning framework. The APPLE Planning Framework has a set of questions/prompts that guide the intervention planning process and conceptual model templates to organize planning efforts for designing intervention research.

CONCLUSIONS

The APPLE Framework for Planning PA Opportunities for Youth will enable researchers to develop comprehensive conceptual models to guide the design of PA interventions for youth. Future research should refine the model and its components to enable PA intervention research in youth to move forward.

Policies and opportunities for physical activity engagement in Austrian schools: a census survey

Background

Compelling evidence suggests that schools' infrastructure and policy represent potential predictors of health and physical activity (PA) in children and adolescents. However, the translation of these findings into practice has not been examined. This study investigated the activity friendliness of Austrian schools.

Methods

Using a census sampling method, principals of Austrian schools (n = 342) were invited to participate in an online survey assessing 1) the availability of PA facilities (e.g. playgrounds, sports courts, swimming halls) and 2) applied PA policies (e.g. cooperation with sports clubs and involvement in PA projects).

Results

A total of 130 principals answered the survey which corresponds to a minimal response rate of 38%. While most schools (87.4%, n = 111) had a gymnastic hall, only one third (37%, n = 47) had access to a swimming hall. On average, the schools had 4.2 ± 2 PA facilities with significant variation between school types (i.e., high schools: 5 ± 2 vs. primary schools: 3.5 ± 2, p < 0.05). The most common facilities were meadow areas (89%, n = 113), sports fields (71.7%, n = 91), and playgrounds (64.6%, n = 82). Almost half of the schools were part of a PA project (e.g. "active break", 45%, n = 56) and offered extracurricular PA programs and courses (54%, n = 67), but only one in five (22%, n = 27) regularly conducted fitness tests. PA policies varied between school types (p < 0.05) but almost all principals (94%, n = 117) would welcome a stronger promotion of activity friendliness at their school.

Conclusion

Schools are mostly activity-friendly regarding infrastructure although the limited possibilities for swimming lessons seem worrisome. PA promotion through projects, extracurricular PA offerings and fitness tests may be expanded.

A cross-sectional analysis between physical activity levels, weight status and empathy-related behaviors in a sample of Tuscany primary school children

BACKGROUND

The present study aimed to investigate the relationship between physical activity (PA) and the development of relational empathy skills in children, taking into account weight status.

METHODS

Parents/guardians of primary school children were involved in filling out a questionnaire: the Empathy Questionnaire (EmQue-I13) and children were asked to complete the Physical Activity Questionnaire for Children (PAQ-C) to investigate the self-reported PA levels. The weight status was assessed using a self-reported Body Mass Index (BMI).

RESULTS

Three hundred seventy parents or guardians of students who attended primary school (8.53±1.61 yrs) were recruited. The total score was 2.41±0.89 for PAQ-C and 41.17±6.32 for EmQue-I13. The three domains of EmQue-I13 were: contagion (8.16±2.67), attention to others' feelings (19.40±2.99) and prosocial actions (13.62±3.01). Linear regression models showed that a higher PAQ-C score was positively associated with empathy-related total score P<0.000. Weight status, age and gender were not associated with EmQue-I13.

CONCLUSIONS

Our results underline the positive association between physical activity and the development of relational empathic skills.

Physically active learning for children with learning disorders attending special-needs schools: A program evaluation

BACKGROUND

Physically active learning (PAL) is a potentially valuable method to stimulate academic performance and physical activity (PA) in children with learning disorders (LD) attending special-needs schools. It is yet unknown whether PAL can be successfully implemented in special-needs schools.

AIMS

This study aimed to evaluate a PAL-program in special-needs schools by examining teacher's dose delivered, children's dose received, and associations of children's characteristics with dose received.

METHODS

Children (N = 37) from two special-needs schools participated in a six-week PAL-program. Dose delivered was evaluated based on PAL-lessons' implementation rate and duration. Dose received was assessed through time-on-task observations (n = 23) and PA (n = 37). To assess the association between dose received and children's characteristics (sex, behavioral disorders, motor skills, and physical fitness), Mann-Whitney U tests and Spearman's rho correlations were used.

RESULTS

For teacher's dose delivered, the implementation rate exceeded 95%, and the PAL-lessons lasted the intended 12 minutes. For dose received, children's on-task behavior was above 79%, and children spent 43% of the time in moderate-to-vigorous PA during PAL. Motor skills were positively related to on-task behavior related to the movements, and physical fitness was positively related to moderate-to-vigorous PA.

CONCLUSIONS

PAL was successfully implemented in terms of dose delivered and dose received for children with LD attending special-needs schools.

Effects of School-Based High-Intensity Interval Training on Hemodynamic Parameters and Heart Rate Variability: A Randomized Controlled Trial

ABSTRACT

Ketelhut, S, Ketelhut, K, Ketelhut, SR, and Ketelhut, RG. Effects of school-based high-intensity interval training on hemodynamic parameters and heart rate variability: A randomized controlled trial. J Strength Cond Res 38(6): 1033-1040, 2024-The purpose of this study was to assess the effects of a child-specific school-based high-intensity interval training (HIIT) implemented into physical education (PE) classes on various hemodynamic parameters and heart rate variability indices. Forty-six students (age 11 ± 1 year) were randomized into an intervention (INT n = 22) and a control group (CON n = 24). During a 12-week period, the INT and CON groups participated in regular PE twice weekly (45-90 minutes). The INT group received HIIT during the first 20 minutes of the 2 PE classes. Systolic and diastolic blood pressure, total peripheral resistance, aortic pulse wave velocity (aPWV), heart rate, SD of normal to normal heartbeat intervals, the root mean square of successive differences between normal heartbeats (RMSSD), the proportion of differences between adjacent normal to normal heartbeat intervals of more than 50 ms, low-frequency power, high-frequency power, and the LF/HF ratio were assessed before and after the experimental period. A p value ≤0.05 was considered statistically significant. Forty students (20 INT; 20 CON) were included in the analysis. A significant time × group interaction was detected for aPWV ( p = 0.05, η2 = 0.099), RMSSD ( p = 0.010, η2 = 0.161), low-frequency power ( p = 0.009, η2 = 0.165), high-frequency power ( p < 0.001, η2 = 0.272), and the LF/HF ratio ( p < 0.001, η2 = 0.354). The INT group revealed significant improvements for the respective parameters. School-based HIIT can induce improvements in cardiovascular parameters. These results highlight the potential of embedding HIIT within the school setting, offering a time-efficient exercise intervention.

Effect of capacity building interventions on classroom teacher and early childhood educator perceived capabilities, knowledge, and attitudes relating to physical activity and fundamental movement skills: a systematic review and meta-analysis

BACKGROUND

Capacity building may play an important role in improving classroom teachers' and early childhood educators' (ECE) capacity to implement physical activity and FMS interventions. Capacity building is the development of knowledge, skills, and structures to improve the capability of individuals and organisations to achieve effective health promotion. This review aimed to determine the efficacy of capacity building interventions on teachers' and ECEs' perceived capabilities, knowledge, and attitudes relating to physical activity and fundamental movement skills.

METHODS

An exhaustive literature search of six electronic databases was conducted. Controlled, single-group pre-post studies were included if they measured the effect of a capacity building intervention on in-service or pre-service classroom teachers' (primary or secondary) or ECEs' physical activity or fundamental skills related perceived capabilities, knowledge, or attitudes. The effects of interventions were synthesised using random effects meta-analysis. Subgroup analysis and meta-regression was conducted to determine if the effects differed based on study design, type of teacher (ECE vs. primary school), or teacher level (pre-service vs. in-service).

RESULTS

A total of 22 studies reporting on 25 unique samples were included in the meta-analyses. Only studies reporting on ECEs and primary school teachers were identified. Interventions most commonly included training/professional development, resources and toolkits, communities of practice, mentorships, and ongoing support. Results showed that capacity building interventions significantly improved teachers' and ECEs' perceived capabilities (g = 0.614, 95% CI = 0.442, 0.786), knowledge (g = 0.792 95% CI = 0.459, 1.125), and attitudes (g = 0.376 95% CI = 0.181, 0.571). The effects did not differ significantly as a function of any of the moderators examined.

CONCLUSION

Findings from this review provide strong support that capacity building interventions are efficacious at improving teachers' and ECEs' perceived capabilities, knowledge, and attitudes related to promoting physical activity and teaching fundamental movement skills. Pre-service teachers and ECEs should be provided training in physical activity and fundamental movement skills as part of their degrees, and continual professional development and capacity building should be offered to in-service teachers and ECEs to promote physical activity and fundamental movement skills in children.

Was it a HIIT? A process evaluation of a school-based high-intensity interval training intervention

BACKGROUND

Despite a growing body of research investigating high-intensity interval training (HIIT) in schools, there are limited process evaluations investigating their implementation. This is concerning because process evaluations are important for appropriately interpreting outcome findings and augmenting intervention design. This manuscript presents a process evaluation of Making a HIIT, a school-based HIIT intervention.

METHODS

The Making a HIIT intervention spanned 8 weeks and was completed at three schools in Greater Brisbane, Australia. Ten classes (intervention group) completed 10-min teacher-led HIIT workouts at the beginning of health and physical education (HPE) lessons, and five classes (control group) continued with regular HPE lessons. The mixed methods evaluation was guided by the Framework for Effective Implementation by Durlak and DuPre.

RESULTS

Program reach: Ten schools were contacted to successfully recruit three schools, from which 79% of eligible students (n = 308, x ¯ age: 13.0 ± 0.6 years, 148 girls) provided consent. Dosage: The average number of HIIT workouts provided was 10 ± 3 and the average number attended by students was 6 ± 2. Fidelity: During HIIT workouts, the percentage of time students spent at ≥ 80% of maximum heart rate (HRmax) was 55% (interquartile range (IQR): 29%-76%). Monitoring of the control group: During lessons, the intervention and control groups spent 32% (IQR: 12%-54%) and 28% (IQR: 13%-46%) of their HPE lesson at ≥ 80% of HRmax, respectively. Responsiveness: On average, students rated their enjoyment of HIIT workouts as 3.3 ± 1.1 (neutral) on a 5-point scale. Quality: Teachers found the HIIT workouts simple to implement but provided insights into the time implications of integrating them into their lessons; elements that helped facilitate their implementation; and their use within the classroom. Differentiation: Making a HIIT involved students and teachers in the co-design of HIIT workouts. Adaption: Workouts were modified due to location and weather, the complexity of exercises, and time constraints.

CONCLUSION

The comprehensive evaluation of Making a HIIT provides important insights into the implementation of school-based HIIT, including encouragings findings for student enjoyment and fidelity and recommendations for improving dosage that should be considered when developing future interventions.

TRIAL REGISTRATION

ACTRN, ACTRN12622000534785 , Registered 5 April 2022 - Retrospectively registered.

'We get to learn as we move': effects and feasibility of lesson-integrated physical activity in a Swedish primary school

BACKGROUND

Physical activity (PA) promotes health in adults as well as children. At the same time, a large proportion of children do not meet the recommendations for PA, and more school-based efforts to increase PA are needed. This study investigates the effectiveness and feasibility of lesson-integrated PA in a Swedish primary school.

METHODS

We evaluate a new method called 'Physical Activity and Lesson in Combination' (abbreviated FALK in Swedish) using a mixed methods approach; a quasi-experimental study followed by qualitative interviews. Two schools participated in the study, one constituting the intervention group (I-school, n = 83) and the other the control group (C-school, n = 81). In addition to regular physical education, the I-school had three 30-minute FALK lessons each week. A total of 164 students aged 7-9 years wore pedometers for a whole week, four times over two semesters, and the number of steps per day (SPD) and the proportion of students with < 10,000 SPD were compared. Statistical differences between the schools were tested with ANOVA, Chi2, t-tests, and ANCOVA. Interviews with students (n = 17), parents (n = 9) and teachers (n = 9) were conducted and analysed using qualitative content analysis.

RESULTS

The results show that FALK led to the I-school getting more SPD and fewer students with < 10,000 SPD. Also, FALK was experienced as a positive, clear, and flexible method, simultaneously encouraging PA and learning. Challenges experienced concerned the teachers' work situation, time, finding suitable learning activities, outdoor school environment changes, and extreme weather conditions.

CONCLUSIONS

This study indicates that FALK has the desired effects on PA and is a feasible method of integrating PA into theoretical teaching. We conclude that FALK is worth testing at more schools, given that implementation and sustainment of FALK considers both general enablers and barriers, as well as context-specific factors at the individual school.

Effectiveness of Intervention Strategies to Increase Adolescents' Physical Activity and Reduce Sedentary Time in Secondary School Settings, Including Factors Related to Implementation: A Systematic Review and Meta-Analysis

BACKGROUND

Globally, just one in five adolescents meet physical activity guidelines and three-quarters of the school day is spent sitting. It is unclear which types of school-based interventions strategies increase physical activity and reduce sedentary time among adolescents, or how these interventions are implemented influences their effectiveness.

OBJECTIVE

The three aims of our systematic review were to (a) identify intervention strategies used within secondary school settings to improve students' movement behaviours throughout school-based initiatives, delivered at or by the school; (b) determine the overall effect of the interventions (meta-analysis) on physical activity (all intensities), sedentary time, cognitive/academic, physical health and/or psychological outcomes; and (c) describe factors related to intervention implementation.

METHODS

Searches were conducted in MEDLINE complete, EMBASE, CINAHL, SPORTDiscus, APA PsycINFO, and ERIC in January 2023 for studies that (a) included high school-aged adolescents; (b) involved a school-based intervention to increase physical activity and/or decrease sedentary time; and (c) were published in English. Reported effects were pooled in meta-analyses where sufficient data were obtained.

RESULTS

Eighty-five articles, representing 61 interventions, met the inclusion criteria, with 23 unique intervention strategies used. Interventions that involved whole-school approaches (i.e., physical activity sessions, environmental modifications, teacher training, peer support and/or educational resources) were favourably associated with most of the outcomes. The meta-analyses showed: (a) non-significant effects for sedentary time (Standardized mean difference [SMD] = -0.02; 95%CI, -0.14, 0.11), physical activity at all intensities (light: SMD= -0.01; 95%CI, -0.08, 0.05; moderate: SMD = 0.06; 95%CI, -0.09, 0.22; vigorous: SMD = 0.08; 95%CI, -0.02, 0.18; moderate-to-vigorous: SMD = 0.05; 95%CI, -0.01, 0.12) and waist circumference (SMD = 0.09; 95%CI, -0.03, 0.21), and (b) a small statistically significant decrease in body mass index (SMD= -0.09, 95%CI -0.16, -0.0). Factors related to intervention implementation were reported in 51% of the articles.

CONCLUSION

While some intervention approaches demonstrated promise, small or null effects were found in meta-analyses. Future school-based interventions should utilize a whole-school approach designed to increase adolescents' activity across the day. Consistent reporting of implementation will increase understanding of how interventions are adopted, implemented and sustained.

REGISTRATION

PROSPERO (CRD42020169988).

Study protocol for the ACTIVE SCHOOL study investigating two different strategies of physical activity to improve academic performance in Schoolchildren

BACKGROUND

Previous research has suggested that school-based physical activity (PA) interventions may have a positive impact on academic performance. However, existing literature on school-based interventions encompasses various forms of PA, spanning from vigorous intensity PA outside the academic classes to light intensity PA and movement integrated into academic learning tasks, and results on academic performance are inconclusive. ACTIVE SCHOOL will implement two different PA interventions for one school year and assess the effects on the pupils' academic performance, with math performance as the primary outcome.

METHODS/DESIGN

The ACTIVE SCHOOL project consists of two phases: 1) Development phase and 2) Randomized Controlled Trial (RCT). In phase one, two interventions were developed in collaboration with school staff. The two interventions were tested in an 8-weeks feasibility study. In phase two, a RCT-study with three arms will be conducted in 9-10-year-old children for one school year. The RCT-study will be carried out in two intervention rounds during the school years 2023/2024 and 2024/2025. Schools will be randomized to one of two interventions or control;1) Run, Jump & Fun intervention (4 × 30 min/week of moderate-to-vigorous physical activity; 2) Move & Learn intervention (4 × 30 min/week focusing on embodied learning in math and Danish lessons); or 3) a control condition, consisting of normal teaching practices. Outcome measures include academic performance, PA level, cognitive functions, cardiorespiratory fitness, anthropometry, well-being and school motivation (collected before, during and after the intervention period). A process evaluation will be conducted to assess implementation.

DISCUSSION

The ACTIVE SCHOOL study will expand knowledge regarding the impact of PA on academic performance. The study will have the potential to significantly contribute to future research, as well as the scientific and educational debate on the best way to implement PA to support education and learning.

TRIAL REGISTRATION

The study was registered on the 25th of October 2022 in ClinicalTrials.gov, NCT05602948.

Investigating Facilitators and Barriers for Active Breaks among Secondary School Students: Formative Evaluation of Teachers and Students

Physical activity in the form of "active breaks" can be combined with academic instruction in primary school. However, few studies have examined the feasibility of conducting active breaks in secondary school. To address this gap, we conducted focus groups (FGs) regarding the implementation of an active breaks (ABs) protocol with 20 teachers and 10 secondary school students. Barriers/facilitators toward the implementation of ABs were classified using grounded theory inductive methods framed by the socio-ecological model. Individual-level factors were instrumental for both teachers and students. Teachers highlighted personal fears and concerns regarding using ABs, while students reported fears related to peer behaviour during the activity. Both teachers and students agreed that ABs can improve cognitive skills and time-on-task behaviour. Teachers articulated concerns related to student behaviour during ABs including possible social exclusion and injury. Students felt that ABs might affect classroom management and interfere with maintaining students' academic focus. Teachers underscored that ABs required social support from the administration and colleagues. Students felt that ABs could support teachers' instructional focus and provide them with an energy respite. Collectively, the FGs suggested that environmental limitations could hinder the implementation of ABs. Involving teacher and student feedback during the codesign phase can rationally inform the design of school-based ABs.

Effects of the inclusion of physical activity in secondary education academic classes on educational indicators and health markers: rationale and methods of the ACTIVE CLASS study

Background

Increasing physical activity (PA) levels and reducing sedentary behaviors in children and adolescents is a need, especially in schools. Active breaks and physically active learning are examples of two emerging methodologies that have been shown to be effective in increasing PA levels and additionally produce improvements in children's educational markers. However, the evidence in adolescents is very limited. This paper presents the design, measurements, and interventions implemented in the ACTIVE CLASS study, whose objectives are: (i) evaluate the effects of two interventions on PA levels, sedentary time, health-related physical fitness academic indicators, cognition, and markers of psychological health among secondary education students; (ii) evaluate teachers' and students' experiences about the implementation of these the two school-based PA intervention.

Methods

A randomized controlled study is conducted with a total of 292 students aged 12-14 years old from six schools (7th and 8th grade) in Spain (three in Cadiz and three in Caceres). One school from each study provinces is randomly assigned to either the active break intervention group, the physically active learning intervention group, or the control group. The interventions have a duration of 16 weeks. Nine main measurement categories are assessed: PA and sedentary time, health-related physical fitness, academic indicators, cognition, psychological health, motivational variables, dietary patterns, sociodemographic characteristics, as well as qualitative information through semi-structured individual interviews and focus groups. Three independent measurements of evaluation are distinguished: pre-intervention, post-intervention (week 16) and retention measurement (4 weeks after the intervention). For quantitative variables, descriptive, correlational, regression and repeated measures ANOVA will be applied.

Discussion

To the best of our knowledge, the ACTIVE CLASS study is the first of its kind in Spain to evaluate the effects of incorporating active breaks and physically active learning in secondary education. In addition, this project provides important information on the effects of two school-based PA intervention arms on educational variables and health markers in adolescents. This will provide valuable and innovative training to the educational community, enabling them to implement teaching methodologies that have the potential to enhance academic performance and improve the quality of life for their students.

Clinical trial registration

clinicaltrials.gov, NCT05891054.

Outdoor Time in Childhood: A Mixed Methods Approach to Identify Barriers and Opportunities for Intervention in a Racially and Ethnically Mixed Population

A growing body of literature suggests that outdoor time is beneficial for physical and mental health in childhood. Profound disparities exist in access to outdoor spaces (and the health benefits thereof) for children in communities of color. The objectives of this research were to: (1) identify challenges and solutions to outdoor time for children; (2) assess the importance of outdoor time for children; and (3) evaluate results stratified by race/ethnicity. Using a convergent mixed methods approach, we conducted a thematic analysis from 14 focus groups (n = 50) with outdoor educators, parents with children attending outdoor preschools, and community members with children. In addition, 49 participants completed a survey to identify challenges and solutions, perceived importance, and culturally relevant perspectives of outdoor time. The main challenges identified for outdoor time were safety concerns, inclement weather, lack of access to outdoor spaces, and parent work schedules. The primary proposed solution was integrating outdoor time into the school day. Nearly all participants, independent of racial identity, reported that outdoor time improved physical and mental health. Overall outdoor time was lower in participants from communities of color (~8 h/week) compared to their White counterparts (~10 h/week). While 50% of people of color (POC) reported that outdoor time was an important cultural value, only 18% reported that people in their respective culture spent time outside. This work contributes to accumulating knowledge that unique barriers to outdoor time exist for communities of color, and the children that live, learn, and play in these communities. Increasing outdoor time in school settings offers a potential solution to reduce identified barriers and to promote health equity in childhood.

The effects of an active breaks intervention on physical and cognitive performance: results from the I-MOVE study

BACKGROUND

The present quasi-experimental study aimed to evaluate the effects of active breaks intervention (ABs) to promote physical and cognitive improvement in primary school.

METHODS

The active breaks group (ABsG) performed 10 min of ABs three times per school day and the control group (CG) did normal lessons. The baseline and follow-up evaluation was conducted respectively in October 2019 and in May 2021. Cognitive performance was assessed using working memory test, physical performance was analyzed with ActiGraph accelerometers and physical fitness tests, quality of life was monitored using the Paediatric Quality of Life questionnaire (PedsQL) and classroom behavior was collected with an ad hoc questionnaire.

RESULTS

We enrolled 153 children (age: 7.61 ± 1.41, 54.2% males). Working memory significantly increased in the ABsG (ΔWM: 1.30 ± 1.17) than in CG (ΔWM: 0.96 ± 1.20). The 6 min Cooper test increased in the ABsG (Δ: 1.77 ± 136.03) but not in CG (Δ: -156.42 ± 187.53), P < 0.05. The weekly physical activity levels increased in both groups; however, the sedentary behavior significantly increased both in ABsG and CG. Children reported improvements in their quality of school life including feeling better in class and in school when using ABs; moreover, children improved their time on task behaviors in ABsG.

CONCLUSION

The present study has proven to be effective on children's physical and cognitive performance.

Promoting physical activity and academic achievement through physically active learning: Qualitative perspectives of co-design and implementation processes

This article discussed the issue of low PA levels among school-aged children and highlights the promising approach of school-based interventions, including physically active learning (PAL), to increase PA levels. The study aimed to co-design and to assess the implementation of a PAL program for 8 weeks in 4 elementary classrooms (82 students and 7 teachers), emphasizing the potential of integrating PA with academic learning and the importance of co-designing programs with teachers to maximize their effectiveness. Technology was found to support PAL practices in promoting PA and academic achievement. The study underscores the need for further research to explore the societal implications of PAL programs, including their potential to improve the health and well-being of children while promoting positive academic outcomes.

Reframing physically active learning as movement-centred pedagogy: a European priority action framework

BACKGROUND

Physically active learning (PAL) has emerged as a promising way of eliciting health and education-based outcomes for pupils. Concurrently, research suggests large variability in how PAL is perceived, operationalized, and prioritized in practice across Europe. Therefore, this study aimed to co-develop a framework for action to support the adoption and implementation of PAL.

METHODS

Adopting a design thinking approach, 40 international stakeholders representing 13 countries engaged in an idea generation workshop during a two-day PAL international conference. Participants included professionals from research (n = 20), practice (n = 4) and policy (n = 1) or a combination (n = 15). Their experience with PAL ranged from none to 19 years (with an average of 3.9 years). Participants were allocated into one of six heterogeneous and multidisciplinary groups and led through interactive tasks to identify: the landscape for PAL across Europe, barriers to the adoption and implementation of PAL, and key objectives for research, policy and practice to improve the adoption and implementation of PAL. All discussions were audio recorded and prioritized objectives were transcribed verbatim and analysed using inductive qualitative content analysis.

RESULTS

Five interlinked and mutually reinforcing themes were identified: (1) Integration of the health and education paradigms (2) Coherent national policy and decision making (3) Building confident and competent teachers (4) Adopting a whole school approach for PAL (5) Strengthening the evidence base for PAL.

CONCLUSIONS

The priority action framework identifies five key areas for action to facilitate PAL adoption and implementation across Europe. Central to the success of border uptake of PAL is the integration of the health and education paradigms. To achieve this aim, reframing PAL as movement-centered pedagogy would provide a more holistic and inclusive perspective.

Elementary school staff perspectives on the implementation of physical activity approaches in practice: an exploratory sequential mixed methods study

Introduction

A whole-of-school approach is best to promote physical activity before, during, and after school. However, multicomponent programming is often complex and difficult to deliver in school settings. There is a need to better understand how components of a whole-of-school approach are implemented in practice. The objectives of this mixed methods study were to: (1) qualitatively explore physical activity approaches and their implementation in elementary schools, (2) quantitatively assess implementation levels, and (3) examine associations between school-level physical activity promotion and academic ratings.

Methods

We used an exploratory sequential mixed methods design. We conducted semi-structured qualitative interviews with elementary school staff from a Texas school district and used a directed content analysis to explore physical activity approaches and their implementation. Using qualitative findings, we designed a survey to quantitatively examine the implementation of physical activity approaches, which we distributed to elementary staff district wide. We used Pearson correlation coefficients to examine the association between the amount of physical activity opportunities present in individual schools and school-level academic ratings.

Results

We completed 15 interviews (7 principals/assistant principals, 4 physical educators, and 4 classroom teachers). Elementary school teachers and staff indicated PE and recess implementation was driven from the top-down by state and district policies, while implementation of classroom-based approaches, before and after school programming, and active transport were largely driven from the bottom-up by teachers and school leaders. Teachers and staff also discussed implementation challenges across approaches. Survey respondents (n = 247 from 22 schools) indicated 54.6% of schools were implementing ≥135 min/week of physical education and 72.7% were implementing 30 min/day of recess. Classroom-based approaches were less common. Twenty-four percent of schools reported accessible before school programs, 72.7% reported accessible after school programs, and 27% promoted active transport. There was a direct association between the number of physical activity opportunities provided and school-level academic ratings r(22) = 0.53, p = 0.01.

Conclusion

Schools provided physical activity opportunities consistent with a whole-of-school approach, although there was variability between schools and implementation challenges were present. Leveraging existing school assets while providing school-specific implementation strategies may be most beneficial for supporting successful physical activity promotion in elementary schools.

A Classroom-Based Intervention to Promote Physical Literacy in Children: ALPHYL Study Protocol

Physical literacy is crucial for children's appropriate development and physical, social and mental health. In a school setting, class-based physical activity (PA) interventions are considered to be appropriate programs to foster PA participation and cognitive development. The purpose of this project, named the Active Learning in PHYsical Literacy (ALPHYL) study, was to describe a multicomponent classroom-based physically-active learning randomised control trial (RCT) in primary school children. The main purpose was to promote children's physical literacy, academic achievement and cognitive function. The ALPHYL study is mainly based on physical literacy, active school models and the Supportive, Active, Autonomous, Fair and Enjoyable principles. The ALPHYL is an 8-10-week RCT to be conducted in six primary schools (12 classes) in Valencia (Spain) and its metropolitan area. Schools will be randomly assigned to the intervention or waiting-list control group. After a 30 h in-person training course for teachers and weekly meetings in the three months of resource preparation, the ALPHYL intervention will be conducted in physical education (PE) and non-PE lessons by teachers. The intervention consists of at least three daily sessions of physically active learning in addition to model-based PE teaching. Its feasibility will be evaluated weekly according to the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. To assess its effectiveness, a pre-test, post-test and retention (8-10 weeks post-intervention) with primary outcomes (i.e., PA level, motor competence, perceived motor competence and PL, motivation, perceived social support, academic achievement and cognitive function), secondary outcomes and covariates will be collected.

Effects of two years of physically active lessons on cognitive indicators in children

Our purpose was to evaluate the effect of physically active lessons (PAL) on the cognitive performance of children during two years of follow-up. Four classes (second grade of elementary school) were divided into two intervention classes (n = 34) and two control classes (n = 27). Evaluations were performed before the intervention (M1), after 3 (M2) and 9 (M3) months in the 1st year, and 14 (M4) and 18 (M5) months in the 2nd year. The intervention was based on PAL integrated with the curricular components, which stimulated the children to stand or move in the classroom. Cognitive performance was evaluated using three computerized tests for response inhibition, selective attention, and cognitive flexibility. The children in the intervention classes presented improved cognitive performance in the execution of all tasks along the two years follow-up, in both correct answers and time reactions, with exception of correct answers of visual search. For the intervention classes, in most of the tasks, the mean differences confidence interval of 95% did not include the 0 on the two last moments of evaluation, and in all cases, the mean differences of them between M1 versus M5 were significantly different with high values of effect size (cohen -d > 1). PAL promotes modest improvements in diverse cognitive functions in children.

How to select interventions for promoting physical activity in schools? Combining preferences of stakeholders and scientists

BACKGROUND

The failure to scale-up and implement physical activity (PA) interventions in real world contexts, which were previously successful under controlled conditions, may be attributed to the different criteria of stakeholders and scientists in the selection process of available interventions. Therefore, the aim of our study was to investigate and compare the criteria applied by local stakeholders and scientists for selecting amongst suitable school-based PA interventions for implementation.

METHODS

We conducted a three-round repeated survey Delphi study with local stakeholders (n = 7; Bremen, Germany) and international scientific PA experts (n = 6). Independently for both panels, two rounds were utilized to develop a list of criteria and the definitions of criteria, followed by a prioritization of the criteria in the third round. For each panel, a narrative analysis was used to rank-order unique criteria, list the number of scorers for the unique criteria and synthesize criteria into overarching categories.

RESULTS

The stakeholders developed a list of 53 unique criteria, synthesized into 11 categories with top-ranked criteria being 'free of costs', 'longevity' and 'integration into everyday school life'. The scientists listed 35 unique criteria, synthesized into 7 categories with the top-ranked criteria being 'efficacy', 'potential for reach' and 'feasibility'. The top ranked unique criteria in the stakeholder panel were distributed over many categories, whereas four out of the top six criteria in the scientist panel were related to 'evidence'.

CONCLUSIONS

Although stakeholders and scientists identified similar criteria, major differences were disclosed in the prioritization of the criteria. We recommend an early collaboration of stakeholders and scientists in the design, implementation, and evaluation of PA interventions.

Individual and Contextual Factors Associated with Classroom Teachers' Intentions to Implement Classroom Physical Activity

Classroom-based physical activity (CPA) is an evidence-based practice that improves student physical activity outcomes, but national data suggest implementation is insufficient in US classrooms. The purpose of this study was to examine individual and contextual factors associated with elementary school teachers' intentions to implement CPA. We collected input survey data from 181 classroom teachers (10 schools; 98.4% participation among eligible teachers) across three separate cohorts to examine associations between individual and contextual constructs and future CPA implementation intentions. Data were analyzed using multilevel logistic regression. Individual-level characteristics of perceived autonomy for using CPA, perceived relative advantage/compatibility of CPA, and general openness to educational innovations were positively associated with intentions to implement CPA (p < 0.05). Teacher perceptions of contextual factors such as administrator support for CPA were also associated with implementation intentions. This study adds to prior evidence about the importance of theoretically determined constructs for understanding behavioral intentions among front-line implementers such as classroom teachers. Additional research is needed to evaluate interventions designed to change malleable factors, including teachers' perceptions, as well as changing school environments so that teachers perceive more autonomy to use CPA and have the training and resources that build skills for implementation.

Effects of prolonged sitting and physical activity breaks on measures of arterial stiffness and cortisol in adolescents

AIM

In adults, prolonged periods of sitting have been linked to acute negative effects on vascular structure and function. The aim of this study was to evaluate the acute effects of physical activity (PA) breaks during prolonged sitting on arterial stiffness, cortisol and psychological factors in adolescents.

METHODS

Adolescents underwent different short (3-min) breaks starting every 20 min, during 80 min of sitting on three separate days. Breaks were (A) social seated breaks (SOC), (B) low-intensity simple resistance activity PA breaks (SRA) and (C) moderate-intensity step-up PA breaks (STEP). The arterial stiffness measures were augmentation index (AIx), AIx@75 and pulse wave velocity (PWV). Cortisol was measured from saliva. Psychological factors were self-reported.

RESULTS

Eleven girls and six boys (average age 13.6 ± 0.7 years) participated, with average baseline heart rates of 72 ± 11 bpm, systolic/diastolic blood pressure 111 ± 7/64 ± 6 mmHg and cortisol 10.9 ± 5.8 nmoL/L. PWV, cortisol and psychological factors did not change after any of the conditions. AIx@75 increased significantly (4.9 ± 8.7-9.2 ± 13.2) after the STEP intervention compared with SOC and SRA (time × condition p < 0.05).

CONCLUSION

Arterial stiffness increased after prolonged sitting with frequent, short step-up activity breaks. The results indicate potential important intensity-dependent effects of physical activity on vascular regulation in youth.

The Effects of the ACTIVE VALUES Program on Psychosocial Aspects and Executive Functions

The main objective of this study was to implement an educational program named ACTIVE VALUES and to analyse the psychosocial and cognitive effects of its application. It is a quasi-experimental repeated measures research with a non-randomised experimental group (EG) and a control group (CG). The sample consisted of 102 students in the 6th grade of primary school, aged between 11 and 13 years (M = 11.59; SD = 0.60), and 4 teachers aged between 27 and 52 years (M = 38.5). The intervention program lasted 4 months, in which the EG implemented a teaching methodology based on the incorporation of classroom-based physical activity (CB-PA) in the structure of the Teaching for Personal and Social Responsibility (TPSR) model to develop personal and social values in students, as well as to reduce children's sedentary behaviour in the classroom in different educational areas (e.g., mathematics, Spanish language, social sciences and natural sciences), while the CG used a conventional methodology based on direct instruction. The main results found show significant improvements in intrinsic motivation variables (including intrinsic motivation for achievement, stimulating experiences and knowledge), self-determination index, autonomy, relatedness, psychological mediators index, personal and social responsibility, teacher climate, intention to be physically active and executive functions in the EG, while amotivation values increased in the CG. In conclusion, interdisciplinary educational programs based on the combination of pedagogical models and active methodologies are postulated as methodological alternatives to achieve an integral and multilateral development of children and adolescents, as well as to improve the different learning domains of physical education, such as cognitive, social and motor. It is recommended that future research should consider longitudinal designs with mixed methods and follow-up data to assess learning retention, as well as larger samples and the measurement of a greater number of executive functions (e.g., inhibitory control and attention).

Assessing the Impacts of Creating Active Schools on Organisational Culture for Physical Activity

BACKGROUND

National and international guidance recommends whole-school approaches to physical activity, but there are few studies assessing their effectiveness, especially at an organisational level. This study assesses the impact of the Creating Active School's (CAS) programme on organisational changes to physical activity provision.

METHODS

In-school CAS leads completed a 77-item questionnaire assessing school-level organisational change. The questionnaire comprised 19 domains aligned with the CAS framework and COM-B model of behaviour change. Wilcoxon Signed Rank Tests assessed the pre-to-nine-month change.

RESULTS

>70% of schools (n = 53) pre-CAS had inadequate whole-school physical activity provision. After nine months (n = 32), CAS had a significant positive effect on organisational physical activity. The positive change was observed for: whole-school culture and ethos, teachers and wider school staff, academic lessons, physical education (PE) lessons, commute to/from school and stakeholder behaviour.

CONCLUSIONS

This study provides preliminary evidence that CAS is a viable model to facilitate system-level change for physical activity in schools located within deprived areas of a multi-ethnic city. To confirm the results, future studies are required which adopt controlled designs combined with a holistic understanding of implementation determinants and underlying mechanisms.

16 Weeks of Physically Active Mathematics and English Language Lessons Improves Cognitive Function and Gross Motor Skills in Children Aged 8-9 Years

The aim of the present study was to examine the effects of physically active lessons, implemented through the Mathematics and English Language curriculum, on cognitive function and gross motor skill development. Following ethical approval, 192 children aged 8-9 years were randomly allocated to an intervention group (n = 98) or a control group (n = 94). The intervention consisted of 8 h.wk-1 of physically active lessons, equally split between Mathematics and English Language, for 16 weeks. Cognitive function (digit span, coding and arithmetic reasoning) and gross motor skill development (TGMD-3) were assessed at baseline and follow-up. The improvement in every domain of cognitive function was greater in the intervention group compared to the control group (group * time, p = 0.008-0.023, d = 0.34-0.42). Furthermore, total TGMD-3 score (group * time, p < 0.001, d = 1.16) and both sub-scales (locomotor, p < 0.001, d = 0.63; object control, p < 0.001, d = 1.29) also improved by a greater extent in the intervention group than in the control group. These findings suggest that 16 weeks of physically active lessons, taught in both Mathematics and English Language curriculum, synergistically improved cognitive function and gross motor skill development in primary school children aged 8-9 years.

Physical Well-Being of Children and Adolescents during the SARS-CoV-2 Pandemic: Findings from the "Come te la Passi?" Cross Sectional Survey in Bologna, Italy

BACKGROUND

The COVID-19 had a strong impact on the physical and general well-being of the youngest. In Italy, citizens were forced to change their habits, especially during the national lockdown, causing increased levels of sedentary and unhealthy behaviors. "Come te la passi?" was a cross-sectional study aimed at investigating changes in the physical activity levels (PA) and well-being of children and adolescents in the City of Bologna.

METHODS

An anonymous survey was administered to parents/guardians of children and adolescents aged 6-18 years.

RESULTS

1134 questionnaires were collected during June 2021; 457 (40.3%) were females, and the mean age was 13.0 ± 3.4 years. Regarding the general well-being perception, 61.3% of the participants reported concerns about the future, 46.3% reported sleep difficulties, and 72.8% reported experiencing attention difficulty, with higher percentages among adolescents. Considering the PA frequency, an overall reduction was found, with the percentage of those who rarely did PA and those who frequently did PA both increasing. No gender differences were found.

CONCLUSIONS

Our findings suggest that the current pandemic has strongly impacted the well-being of children and adolescents. It appears to have primarily affected adolescents, with a significant reduction in PA levels, even after the end of the national lockdown.

The longitudinal association between objectively-measured school-day physical activity and academic achievement in US elementary school students

Background

It is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement.

Methods

In a diverse suburban public school district, 4936 Grade 4 students were recruited in 40 elementary schools. Students wore accelerometers to measure school-day MVPA for 15 days across three semesters. Academic performance data was collected across Grade 3 fall to Grade 5 spring, including teacher-assigned grades and standardized test scores. Multilevel modeling was conducted controlling for student demographics and school characteristics.

Results

Cross-sectional analyses found small negative associations in Grade 4. Grade 4 full-year mean daily school-day MVPA had β = −-0.066, β = −-0.063, β = −-0.066, and β = −-0.058 associations (p <  0.001) with Grade 4 math, reading, spelling, and writing grades respectively, and Grade 4 full-year mean daily school-day MVPA had β = −-0.206 and β = −-0.283 (p <  0.001) associations with Grade 4 math and English Language Arts (ELA) standardized test scores respectively out of approximately 500 points. Longitudinal analyses found no significant associations between Grade 4 full-year mean daily school-day MVPA and Grade 5 Fall course grades. Results also indicated small negative associations for students attaining 30+ minutes of daily school-day MVPA compared to those attaining less than 15 minutes, but only in Grade 4 Fall cross-sectional analyses where teacher-assigned reading, spelling, and writing grades were − 1.666, − 1.638, and − 1.993 points lower respectively (p <  0.001).

Conclusion

The cross-sectional findings, while statistically significant in a negative direction, have a negligible association when translated practically. For example, even if students attained twice the recommended amount of school-day MVPA – which would constitute an approximately 300% increase from current levels – results suggest that grades would only decrease by 2 points on a 100-point scale. Furthermore, longitudinal analyses suggest school-day MVPA does not have a predictive association with course grades or standardized test scores. Findings suggest school-based MVPA implemented in accordance with recommendations does not meaningfully detract from academic progress.

Trial registration

ClinicalTrials.gov, NCT03765047. Registered 05 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03765047

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-022-01328-7.

Feasibility and Acceptability of a Classroom-Based Active Breaks Intervention for 8-12-Year-Old Children

Purpose: This study explored the feasibility of conducting a classroom-based active breaks intervention on sedentary behavior (SB), physical activity (PA) and attention in 8-12-year-old children. Methods: Eight schools were randomized on a 1:1 basis to the control or intervention. Teachers selected 10 cards detailing an activity break at random. Children then undertook each of the ten activity breaks for 30 s, three times per day for 6 weeks. School and participant recruitment, attrition rates, percentage of outcome measures collected, and acceptability were used to explore the feasibility of the study. Mixed effects models were undertaken to examine intervention effects upon measures of PA, SB and attention. Results: Two hundred and thirty-nine consent forms were issued and 153 were returned (64%). Of the 153 consents, 146 children (95%) were measured at baseline, and 117 participated in the follow-up measures (80%) 6 weeks later suggesting the intervention was acceptable for the participants. From teacher interviews, it was noted that the intervention was feasible to implement, and teachers observed positive classroom behavior changes in children. Inclusion rates for outcome measures ranged from 49% to 66%. Significant, intervention effects were observed for sitting time (B = -27.19; 95%CI: -36.84, -17.17), standing time (B = 23.51; 95%CI 14.1, 32.45) and the number of sit to stand transitions (B = 16.1; 95%CI 4.7, 26.79). Conclusion: Findings suggest that it was feasible and acceptable to implement an active breaks intervention within the classroom setting. Future work should consider the effectiveness of implementing this intervention across a full academic year.

No Motor Costs of Physical Education with Eduball

Numerous neuroscience studies demonstrate that when motor and cognitive tasks are performed simultaneously, there is dual-task interference. Experiments show that the cost is a temporal deterioration in motor functioning. However, there is no comprehensive research on the developmental costs of dual-task exercises incorporated into physical education (PE). Such an approach is called the interdisciplinary model of PE and is used to stimulate cognitive development. Therefore, there is a knowledge gap regarding the motor costs of methods based on this model, e.g., Eduball. The Eduball method integrates core academic subjects with PE using a set of educational balls printed with letters, numbers, and other signs. To fill this knowledge gap, we replicated the Eduball experiment, focusing on motor development. The half-year intervention occurred in one primary school class. The control group was a peer class participating in traditional PE, not based on dual tasks. We tested students' space-time orientation and graphomotor, locomotor, and object control skills. We found no motor costs of the intervention. Eduball-based PE stimulated motor development as much as traditional PE. Our study suggests that methods based on the interdisciplinary model of PE are safe for motor development. As such, it is worth considering their use in children's education.

An Investigation of the Implementation of Obligatory Physical Activity Classes for 5th-7th Grade in Norway

In 2009, all Norwegian 5th-7th graders were allocated 76 h of obligatory physical activity (PA) classes in addition to physical education (PE). The study explores how schools implemented these classes and the relationship with school physical activity guidelines. The sample consisted of 134 schools participating in the WHO collaborative Health Behaviour in School-Aged Children (HBSC) survey in 2014 (n = 69) and 2018 (n = 65). Ten questions concerning PA were asked in 2014, and four of these were included in the 2018 survey. Chi-squared tests were used to investigate differences between groups. In 2014, 51% reported that PE teachers led the classes; this had reduced to 30% in 2018. A combination of teacher- and student-driven activities was most common. More student-led activities were observed when nonpedagogical personnel were responsible for the classes. Most schools reported no professional staff development related to the implementation of obligatory PA. In 2018, schools with written guidelines on physical activity had to a greater extent implemented staff development measures and increased the use of PE teachers compared to 2014. A considerable variation regarding teaching competence, teaching forms, group sizes, and facilities makes the outcome of the PA scheme uncertain. A potential effect of having established written school policies on the implementation of physical activity classes was however found.

The Use of Wearable Activity Trackers in Schools to Promote Child and Adolescent Physical Activity: A Descriptive Content Analysis of School Staff's Perspectives

BACKGROUND

The school environment is an ideal setting for promoting physical activity (PA). Wearable activity trackers (wearables) have previously been implemented, in research, as intervention tools within the school-environment. However, the large-scale use and acceptance of wearables, in schools, is unknown.

METHODS

This study distributed a cross-sectional survey to school staff to investigate the prevalence of child and adolescent wearable use in schools, including when and how they are used, and school staff's willingness to use them in the future (as implemented by school staff). This survey consisted of between 13 and 22 items, including closed-ended and open-ended questions. Closed-ended responses were displayed descriptively (wearable prevalence and characteristics), and open-ended qualitative responses were categorised using descriptive content analysis (how wearables are used).

RESULTS

1087 school staff provided valid responses. Of those, 896 (82.4%) had never used a wearable as a teaching or support tool for their students, and 120 (11%) currently used- and 71 (6.5%) had previously used- a wearable as a teaching or support tool for their students. When wearables were used, school staff implemented their use regularly and during physical education lessons or throughout the entire school day. Wearables were used to monitor or increase student's PA levels, or for student and staff educational purposes (e.g., academic learning, movement breaks). Most school staff were willing to use a wearable as a teaching or support tool to promote student's PA, and/or learning about PA, in the future.

CONCLUSIONS

This study is the first study to explore the widescale use and acceptance of children and adolescents using wearables in the school-setting. Findings may inform the development of future school-based interventions and public health initiatives for physical activity promotion, using wearables.

School health programs of physical education and/or diet among pupils of primary and secondary school levels I and II linked to body mass index: A systematic review protocol within the project From Science 2 School

The most common causes of death in Western countries today are preventable diseases mainly attributed to daily behavior. It has been well documented that genetics are influential but not the deciding factor for developing non-communicable diseases. Ideally, the public should be educated to perform methods of optimal health and wellbeing independently, meaning that individuals should be in control of their health without relying on others. As behavior is known to be consistent over time, good or poor health behavior will track from childhood into adulthood. Physical activity and diet are permanently linked to the individual's state of health, and when properly balanced, the effects on personal health summate, resulting in greater benefits from this dual-approach for public health. The objective is to highlight the different approaches (physical intervention, nutritional intervention, and dual-approach of diet and exercise) and identify effective interventions for sustainable body weight and healthy body mass index in school children. A systematic review will be conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The review will assess school-based diet and exercise interventions on children in primary and secondary school levels I and II. Overweight and obesity develop as a result of a prolonged imbalance in the energy balance model, with both physical activity and diet being influential in the fluctuation of body weight. A dual-approach including physical activity and diet could therefore be a very promising method to promote sustainable healthy body weight in school children.

Comparative Effectiveness of Physical Activity Intervention Programs on Motor Skills in Children and Adolescents: A Systematic Review and Network Meta-Analysis

Objective: To evaluate how different physical activity (PA) interventions (traditional, exergaming, and teacher/parent education) impacted children's motor skills (object control, locomotor, and gross motor). Design: Systematic review and network meta-analysis. Data sources: PubMed, Medline, Scopus, Web of Science, EMBASE, and PsycINFO. Eligibility criteria: (1) Participants comprised 1708 children 3-12 years; (2) PA or exercise-based interventions were investigated; (3) only studies using a Test of Gross Motor Skills assessment were included; (4) RCT were chosen as the study design to assess the impact of PA interventions on children's motor skills; and (5) culture-based PA studies with English language only were included. Data were analyzed using a Bayesian network meta-analysis. Results: The results were reported as standardized mean differences (SMDs) with associated 95% credible intervals (CrIs). For object control, aerobic intervention (SMD 6.90, 95% Crl 1.39 to 13.50); for locomotor, exergaming intervention (SMD 12.50, 95% Crl 0.28 to 24.50); and for gross motor, aerobic intervention (SMD 7.49, 95% Crl 0.11 to 15.70) were the most effective treatments. Conclusion: Children's FMSs have been improved through different PA interventions. Among them, aerobic interventions seem to be the most effective intervention in enhancing object control skills and overall gross motor skills.

Perceived teacher's support and engagement among students with obesity in physical education: The mediating role of basic psychological needs and autonomous motivation

Grounded in self-determination theory, this cross-sectional study aims to explore the multiple mediating roles of perceived teachers' support for students with obesity and their engagement in physical education. The study included 322 Chinese high school students with obesity (mean age, 16.84 [±0.147] years; 219 [68%] male, 103 [32%] female). Mplus 8.3 software was used to test the multiple mediating effects. After controlling for grade and gender, teacher support was found to neither directly affect students' engagement nor directly stimulate their autonomous motivation; however, it could affect their engagement through the two pathways of 1) basic psychological needs and 2) the chain mediation of basic psychological needs and autonomous motivation. Results suggest that not all teacher support, but only teacher support meeting students' basic psychological needs, can promote engagement in PE by students with obesity. Future research should explore strategies according to the physical and mental characteristics of students with obesity, to enrich and innovate the theoretical system of teacher support in physical education. Furthermore, teacher support interventions to promote engagement among students with obesity should be developed.

Understanding the Benefits of Brief Classroom-Based Physical Activity Interventions on Primary School-Aged Children's Enjoyment and Subjective Wellbeing: A Systematic Review

BACKGROUND

Engaging in classroom-based physical activity (PA) breaks may help increase children's subjective wellbeing and enjoyment of PA, important precursors for children to remain engaged in PA. We conducted a systematic review to investigate the effect of brief classroom-based PA interventions on primary school children's subjective wellbeing and enjoyment of PA.

METHODS

Databases were reviewed between the earliest date of records and April 2020. Eligibility criteria included peer-reviewed empirical quantitative or mixed methods studies reporting enjoyment of PA or wellbeing outcomes of participating in a brief classroom-based PA program. Fifteen papers were included. Interventions supported 7022 child participants enrolled at baseline and 6286 children analyzed in interventions across 148 schools.

RESULTS

Thirteen studies examined the effect of brief classroom-based PA interventions on subjective wellbeing. Four found a significant positive effect for children in the intervention group (specifically for children's self-efficacy in learning with video exercises, quality of life, and self-confidence). Eight studies examined the effect of brief classroom-based PA interventions on enjoyment of PA. Five studies reported a positive effect for children in the intervention group and only 1 study found a negative effect for 1 grade level of children in the intervention group. The remaining studies with wellbeing and/or enjoyment outcomes reported no significant effect.

CONCLUSIONS

Findings from these studies indicate that the integration of brief PA breaks may support PA enjoyment and specific self-beliefs and quality of life perceptions that contribute to children's subjective wellbeing. However, more research is needed to confirm this effect.

Effects of In-Classroom Physical Activity Breaks on Children's Academic Performance, Cognition, Health Behaviours and Health Outcomes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

In-Classroom physical activity breaks (IcPAB) are a promising way to promote children’s health behaviors, while contributing to the development of their academic and cognitive ability and health outcomes. Yet the effect of the activity breaks, which are exclusive to classroom settings, are still mixed and unclear. Hence, this review was conducted to identify the characteristics and the effects of IcPAB among primary school children. The review protocol was registered on PROSPERO (CRD42021234192). Following the Cochrane guidelines, PubMed, PsycINFO (ProQuest), MEDLINE (EBSCOhost), Embase/Ovid, SportDISCUS (EBSCOhost), Web of Science, Scopus and Academic Search Premier (EBSCOhost) databases were searched to collect data on randomised control trials without a time restriction. The final database search was conducted on the 8 November 2021. Random effects models were used to calculate the effect sizes. The systematic review identified ten eligible studies, nine of which were also included in the meta-analysis. Few studies used the theoretical frameworks and process evaluations. IcPAB showed mixed effectiveness on academic outcomes: i.e., IcPAB had effects on spelling performance (p < 0.05) and foreign language learning (p < 0.01) but not on mathematics and reading performance. Health behaviors such as moderate-to-vigorous physical activity levels were improved (p < 0.01), but IcPAB did not have an impact on cognition outcomes and health outcomes. Given these mixed results, further research is needed underpinned by strong methodological quality, theoretical underpinnings and reliable process evaluation methods.

Online physically active academic lessons in COVID-19 times: A pilot study

Schools play an important role in promoting physical activity among students. This paper studies the perception of educators, students, and parents about the use of online physically active academic lessons during COVID-19 in the north of Chile. Starting the first week of November 2020, and for a period of five weeks, 323 students, alongside 11 educators, practiced a geometry-based dance routine online. The qualitative analysis results reveal a positive perception of the experience and an increase in physical activity without reducing the amount of time spent on academic activities. There were also improvements in learning, social relationships, and enjoyment.

Physical Education with Eduball Stimulates Non-Native Language Learning in Primary School Students

Although the neuronal mechanisms of action and cognition are related, the division of intellectual and physical lessons is standard in schools. This is surprising, because numerous studies show that integrating physical education (PE) with teaching content stimulates critical skills. For example, several experiments indicate that Eduball-based PE (i.e., lessons in a sports hall during which students play team mini-games with educational balls with printed letters, numbers, and other signs) develops mathematical and language competencies. At the same time, the Eduball method does not slow down learners’ physical development. However, we have little knowledge about the effects of such techniques on non-native language learning. Consequently, the absence of incorporating core academic subjects into PE in dual-language schools or during foreign language education is exceptionally high. Here, we replicated the Eduball experiment, but with the goal of testing this method for non-native language learning. Thus, the intervention occurred in a dual-language primary school and we evaluated second language (L2) learning. As before, we used the technique of parallel groups (experimental and control); in both groups, there were three 45-min PE classes per week. In the experimental class, two of them were held using Eduball. After a half-year experiment, children from the experimental group (one second-grade, N = 14) improved their non-native language skills significantly more than their peers from the control group (one second-grade, N = 12). These findings demonstrate that Eduball-type intervention stimulates non-native language learning in children. Hence, our report suggests that specific body training forms can support L2 learning.

Classroom Movement Breaks and Physically Active Learning Are Feasible, Reduce Sedentary Behaviour and Fatigue, and May Increase Focus in University Students: A Systematic Review and Meta-Analysis

Background: University students are mostly sedentary in tertiary education settings which may be detrimental to their health and learning. This review aimed to examine the feasibility and efficacy of classroom movement breaks (CMB) and physically active learning (PAL) on physical and cognitive outcomes in university students in the tertiary setting. Methods: Five electronic databases (MEDLINE, CINAHL, Embase, PsychINFO, and PubMed) were searched for articles published up until November 2021. Manual searching of reference lists and citation tracking were also completed. Two reviewers independently applied inclusion and exclusion criteria and completed quality assessment. Articles were included if they evaluated CMB or PAL interventions delivered to university students in a tertiary setting. Results: Of the 1691 articles identified, 14 studies with 5997 participants met the inclusion criteria. Average study quality scores were poor for both CMB and PAL studies. CMBs and PAL are feasible in the tertiary setting and increase physical activity, reduce sedentary behaviour, increase wellbeing, and reduce fatigue in university students. In addition, CMBs increased student focus and attention in class and PAL had no detrimental effect on academic performance. Conclusions: University educators should feel confident in introducing CMB and/or PAL interventions into their classes to improve student health and wellbeing.

Evaluation of feasibility, effectiveness, and sustainability of school-based physical activity "active break" interventions in pre-adolescent and adolescent students: a systematic review

Objective

The present systematic review aimed to investigate the impact of school-based physical activity (PA) interventions of “active breaks” on PA levels, classroom behaviour, cognitive functions, and well-being in pre-adolescents and adolescents attending secondary and high school.

Methods

In March 2021, we performed a systematic research in CINAHL, Cochrane Library, Embase, MedLine, and PsycINFO databases and through grey literature. Quality assessment was performed in accordance with the Cochrane Tool for Quality Assessment for RCTs and the STROBE tool for observational studies. We included studies that investigated classroom PA interventions led by teachers such as active breaks or physically active lessons on PA levels, classroom behaviour, cognitive function, and quality of life in pre-adolescent and adolescent population attending secondary and high school.

Synthesis

Three studies met the inclusion criteria. Two studies showed a positive effect of active breaks on students’ classroom behaviour and quality of life. One study registered a positive effect in the increase in school PA levels; unfortunately, this effect was not found in the overall levels of PA or in the reduction of sedentary behaviour. All three studies showed the feasibility and acceptability of active breaks intervention in secondary and high school settings.

Conclusion

This systematic review suggests the potential benefit of this type of intervention integrated in the secondary and high school curriculum on classroom behaviour, school PA levels, and well-being.

Supplementary Information

The online version contains supplementary material available at 10.17269/s41997-022-00652-6.

Trajectories of physical activity and sedentary time in Norwegian children aged 3-9 years: a 5-year longitudinal study

BACKGROUND

Limited evidence exists regarding the longitudinal development of physical activity during early to mid childhood. The aim of this study was to determine physical activity and sedentary time trajectories in children aged 3‒9 years from Western Norway.

METHODS

A sample of 294 children (51% boys; aged 3‒5 years at baseline) from the Sogn og Fjordane Preschool Physical Activity Study was followed annually over 5 years (2015‒2019). Physical activity was measured every autumn during this period using hip-based accelerometry (ActiGraph GT3X+). Data was processed as counts. We used linear mixed models to analyse the data. Primary analyses included trajectories for total and intensity-specific physical activity (light, moderate, vigorous, and moderate to vigorous intensity) and sedentary time for boys and girls using 1-s epoch. Secondary analyses included trajectories for weekdays versus weekend days, preschool/school hours versus after school hours, and 1- versus 60-s epoch lengths.

RESULTS

Over the total day, significant associations with age were found for boys and girls for all physical activity intensities and sedentary time (p < .001). Total physical activity peaked at age 5, whereas intensity-specific physical activity levels peaked at age 3 to 8 years (light intensity: 3-4 years; moderate intensity: 4-7 years; vigorous intensity: 7-8 years; moderate to vigorous intensity: 5-8 years). Boys had higher physical activity levels and more favourable trajectories than girls. Sedentary time increased from ages 3 to 9. Changes over time were larger for weekdays than for weekend days and larger for preschool/school hours than for after school hours. The use of a 60-s epoch resulted in larger changes over time than a 1-s epoch.

CONCLUSIONS

Our findings suggest physical activity levels peaked between the ages of 3 and 8 years. Finding ways to prevent decline in physical activity during the transition from preschool to primary school is important, especially for girls. Standardising epoch length will help when comparing physical activity and sedentary behaviour across studies.

Correlatos de atividade física e comportamento sedentário em crianças pré-escolares sul-americanas: revisão de escopo

Objetivo.

Sintetizar os achados sobre correlatos da atividade física (AF) e do comportamento sedentário (CS) em crianças sul-americanas.

Método.

Realizou-se uma busca dos artigos no período de 24 de junho até 27 de outubro de 2020, nas bases de dados LILACS, PubMed, SciELO, Scopus e Web of Science. Para ampliar a busca, foram examinadas as referências dos artigos de revisão identificados e realizada uma consulta a um painel de especialistas. Foram incluídos estudos com delineamentos observacional e de intervenção com foco em crianças sul-americanas de zero a 5 anos de idade.

Resultados.

Dos 3 111 artigos inicialmente identificados, 18 foram elegíveis: 14 com delineamento observacional, 12 realizados no Brasil e 17 conduzidos com pré-escolares (3 a 5 anos de idade). Além do Brasil, os únicos países representados foram o Chile e o Equador. A AF e o CS foram medidos por acelerômetros em sete estudos, porém houve alta variabilidade nos instrumentos e pontos de corte usados. Embora as crianças tenham sido consideradas fisicamente ativas em 12 estudos, seis estudos mostraram que elas despendiam muito tempo em CS. Os domínios de influência mais avaliados foram o individual (14 estudos) e o interpessoal (11 estudos), seguidos pelo ambiental (oito estudos) e o político (um estudo). As intervenções no contexto escolar (quatro estudos) aumentaram os níveis de AF e diminuíram o tempo em CS. Entretanto, as evidências dos estudos transversais e de intervenção apresentaram alto risco de viés.

Conclusão.

Diante das lacunas identificadas, recomendam-se estudos com delineamentos robustos que incluam mais países sul-americanos, com foco em bebês e crianças com menos de 3 anos de idade e que investiguem correlatos dos domínios ambiental e político.

Classroom Teacher Efficacy Toward Implementation of Physical Activity in the D-SHINES Intervention

BACKGROUND

Given levels of sedentary behavior among youth, teachers have been called upon to increase physical activity (PA) by implementing classroom PA breaks. School-based interventions enacted in classroom settings have shown promise in increasing youth PA. Yet little is known about how teacher efficacy toward implementing classroom PA breaks may influence intervention effects.

PURPOSE

Therefore, the purpose of this study was to examine how the Dearborn School Health through Integrated Nutrition and Exercise Strategies (D-SHINES) intervention, implemented across 8 schools, influenced classroom teacher's efficacy toward providing classroom PA breaks.

METHODS

A mixed-methods design examined classroom teachers' efficacy toward implementing classroom PA breaks and used semi-structured interviews to better understand teachers' efficacy and implementation.

RESULTS

Quantitative results indicated that teacher efficacy significantly increased over the intervention period and that general and institutional efficacy predicted higher amounts of PA breaks offered. Qualitative results suggested that to enhance teachers' facilitation of classroom PA breaks, one must tap into the institutional, student, and educational factors that constitute teacher efficacy.

IMPLICATIONS FOR SCHOOL HEALTH

Designing interventions that focus on teacher efficacy toward classroom PA may be a viable way to increase PA breaks in schools. Implications for the whole school, whole community, whole child model are discussed.

Two-Year Effectiveness of a Controlled Trial With Physically Active Lessons on Behavioral Indicators of School Children

Purpose: In this study, we evaluated the effectiveness of two years of an intervention with physically active lessons on indicators of sedentary behavior and physical activity measured objectively in elementary school children. Methods: A controlled clinical trial with cluster sampling was carried out in 2018 and 2019, with four classes of children in the 2nd year of elementary school. The intervention group classes received dynamic activities linked to the pedagogical content (n = 34) for 2 years. The indicators of sedentary behavior and physical activities were evaluated using ActivPal and ActiGraph GT3X accelerometers during the school shift. Crude and adjusted models of Generalized Estimation Equations with Bonferroni's post hoc were used to identify the differences between the groups (three evaluations in 2018 and two evaluations in 2019). Results: There was a reduction in stationary behavior (p = .01) and an increase in light physical activity (p = .044) during the two years. In the first year there were reductions in standing time (p = .044) and number of transitions (p ≤ .001), and an increase in walking time (p = .017). However, in the second year, the mean differences in percentage points were smaller than in the first year. No differences were found for sitting time as well as for moderate and vigorous physical activity. We observed a large effect size for all variables. Conclusions: The introduction of physically active lessons in the classroom reduced time in stationary behavior and increased time in light physical activity. However, the effects on behavior observed in the first year were not maintained in the second year of intervention.