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Buttazzoni A, Pham J, Nelson Ferguson K, Fabri E, Clark A, Tobin D, Frisbee N, Gilliland J. Supporting children's participation in active travel: developing an online road safety intervention through a collaborative integrated knowledge translation approach. Int J Qual Stud Health Well-being 2024; 19:2320183. [PMID: 38431847 PMCID: PMC10911243 DOI: 10.1080/17482631.2024.2320183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/14/2024] [Indexed: 03/05/2024] Open
Abstract
Even though regular engagement in physical activity (PA) among children can support their development and encourage the adoption of healthy lifelong habits, most do not achieve their recommended guidelines. Active travel (AT), or any form of human-powered travel (e.g., walking), can be a relatively accessible, manageable, and sustainable way to promote children's PA. One common barrier to children's engagement in AT, however, is a reported lack of education and training. To support children's participation in AT, this paper presents the development of a comprehensive 4-module online road safety education intervention designed to improve children's knowledge and confidence regarding AT. Using a qualitative integrated knowledge translation (iKT) approach undertaken with community collaborators (n = 50) containing expertise in health promotion, public safety, school administration, and transportation planning, our inductive thematic analysis generated fourth themes which constituted the foundation of the intervention modules: Active Travel Knowledge: Awareness of Benefits and Participation; Pedestrian Safety and Skills: Roles, Responsibilities, and Rules; Signs and Infrastructure: Identification, Literacy, and Behaviour; Wheeling Safety and Skills: Technical Training and Personal Maneuvers. Each theme/module was then linked to an explicit learning objective and connected to complementary knowledge activities, resources, and skill development exercises. Implications for research and practice are discussed.
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Affiliation(s)
- Adrian Buttazzoni
- School of Planning, University of Waterloo, Waterloo, ON, Canada
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
| | - Julia Pham
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Kendra Nelson Ferguson
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Emma Fabri
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Andrew Clark
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Danielle Tobin
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Nathaniel Frisbee
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
| | - Jason Gilliland
- Human Environments Analysis Laboratory, Department of Geography, Faculty of Social Sciences, University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada
- School of Health Studies, University of Western Ontario, London, Ontario, Canada
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Couture-Wilhelmy L, Chaubet P, Gadais T. Winning Conditions for the Adoption and Maintenance of Long-Term Healthy Lifestyles According to Physical Activity Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111057. [PMID: 34769580 PMCID: PMC8583117 DOI: 10.3390/ijerph182111057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/21/2022]
Abstract
The literature has not yet well documented the relative elements of the adoption of healthy lifestyle habits (HLHs) over the long term. More especially, researchers are calling to complete the corpus with qualitative or mixed estimates that would allow them to better explain the conditions necessary for the adoption or maintenance of HLHs over the long term. The present study seeks to understand the winning conditions for the adoption and maintenance of HLHs. Semi-structured group interviews were conducted with three groups of university students (two in Bachelor’s degree in physical education (PE) and one in Master’s degree in physical activity science), all in favor with HLHs. The results identify some dominant winning conditions in the adoption and maintenance of HLHs, such as the role of the family environment, the role of diversity and choice in physical activities during youth, the physical and social environment, autonomy and also mental health, which is closely linked with physical health. Results were modelled in the form of an ideal pathway, which traces the impact of winning conditions from childhood to adulthood. The originality of this study stands out, among other things, because of its innovative methodology; therefore, this study opens the door to future qualitative research in the field. Investigating pathways, considering the different phases of development of children and adolescents to identify factors of change and maintenance of HLHs now seems to be an interesting and necessary avenue for research in the field.
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Affiliation(s)
- Laurence Couture-Wilhelmy
- Département des Sciences de l’activité Physique, Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada; (L.C.-W.); (P.C.)
- Chaire UNESCO en Développement Curriculaire, Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada
- Centre de Recherche Interdisciplinaire sur la Formation et la Profession Enseignante (CRIFPE), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada
| | - Philippe Chaubet
- Département des Sciences de l’activité Physique, Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada; (L.C.-W.); (P.C.)
- Chaire UNESCO en Développement Curriculaire, Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada
- Centre de Recherche Interdisciplinaire sur la Formation et la Profession Enseignante (CRIFPE), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada
| | - Tegwen Gadais
- Département des Sciences de l’activité Physique, Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada; (L.C.-W.); (P.C.)
- Chaire UNESCO en Développement Curriculaire, Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada
- Centre de Recherche Interdisciplinaire sur la Formation et la Profession Enseignante (CRIFPE), Université du Québec à Montréal, Montréal, QC H2X 1Y4, Canada
- Correspondence: ; Tel.: +1-514-987-3000 (ext. 3704)
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Neil-Sztramko SE, Caldwell H, Dobbins M. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev 2021; 9:CD007651. [PMID: 34555181 PMCID: PMC8459921 DOI: 10.1002/14651858.cd007651.pub3] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity among children and adolescents is associated with lower adiposity, improved cardio-metabolic health, and improved fitness. Worldwide, fewer than 30% of children and adolescents meet global physical activity recommendations of at least 60 minutes of moderate to vigorous physical activity per day. Schools may be ideal sites for interventions given that children and adolescents in most parts of the world spend a substantial amount of time in transit to and from school or attending school. OBJECTIVES The purpose of this review update is to summarise the evidence on effectiveness of school-based interventions in increasing moderate to vigorous physical activity and improving fitness among children and adolescents 6 to 18 years of age. Specific objectives are: • to evaluate the effects of school-based interventions on increasing physical activity and improving fitness among children and adolescents; • to evaluate the effects of school-based interventions on improving body composition; and • to determine whether certain combinations or components (or both) of school-based interventions are more effective than others in promoting physical activity and fitness in this target population. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, BIOSIS, SPORTDiscus, and Sociological Abstracts to 1 June 2020, without language restrictions. We screened reference lists of included articles and relevant systematic reviews. We contacted primary authors of studies to ask for additional information. SELECTION CRITERIA Eligible interventions were relevant to public health practice (i.e. were not delivered by a clinician), were implemented in the school setting, and aimed to increase physical activity among all school-attending children and adolescents (aged 6 to 18) for at least 12 weeks. The review was limited to randomised controlled trials. For this update, we have added two new criteria: the primary aim of the study was to increase physical activity or fitness, and the study used an objective measure of physical activity or fitness. Primary outcomes included proportion of participants meeting physical activity guidelines and duration of moderate to vigorous physical activity and sedentary time (new to this update). Secondary outcomes included measured body mass index (BMI), physical fitness, health-related quality of life (new to this update), and adverse events (new to this update). Television viewing time, blood cholesterol, and blood pressure have been removed from this update. DATA COLLECTION AND ANALYSIS: Two independent review authors used standardised forms to assess each study for relevance, to extract data, and to assess risk of bias. When discrepancies existed, discussion occurred until consensus was reached. Certainty of evidence was assessed according to GRADE. A random-effects meta-analysis based on the inverse variance method was conducted with participants stratified by age (children versus adolescents) when sufficient data were reported. Subgroup analyses explored effects by intervention type. MAIN RESULTS Based on the three new inclusion criteria, we excluded 16 of the 44 studies included in the previous version of this review. We screened an additional 9968 titles (search October 2011 to June 2020), of which 978 unique studies were potentially relevant and 61 met all criteria for this update. We included a total of 89 studies representing complete data for 66,752 study participants. Most studies included children only (n = 56), followed by adolescents only (n = 22), and both (n = 10); one study did not report student age. Multi-component interventions were most common (n = 40), followed by schooltime physical activity (n = 19), enhanced physical education (n = 15), and before and after school programmes (n = 14); one study explored both enhanced physical education and an after school programme. Lack of blinding of participants, personnel, and outcome assessors and loss to follow-up were the most common sources of bias. Results show that school-based physical activity interventions probably result in little to no increase in time engaged in moderate to vigorous physical activity (mean difference (MD) 0.73 minutes/d, 95% confidence interval (CI) 0.16 to 1.30; 33 studies; moderate-certainty evidence) and may lead to little to no decrease in sedentary time (MD -3.78 minutes/d, 95% CI -7.80 to 0.24; 16 studies; low-certainty evidence). School-based physical activity interventions may improve physical fitness reported as maximal oxygen uptake (VO₂max) (MD 1.19 mL/kg/min, 95% CI 0.57 to 1.82; 13 studies; low-certainty evidence). School-based physical activity interventions may result in a very small decrease in BMI z-scores (MD -0.06, 95% CI -0.09 to -0.02; 21 studies; low-certainty evidence) and may not impact BMI expressed as kg/m² (MD -0.07, 95% CI -0.15 to 0.01; 50 studies; low-certainty evidence). We are very uncertain whether school-based physical activity interventions impact health-related quality of life or adverse events. AUTHORS' CONCLUSIONS Given the variability of results and the overall small effects, school staff and public health professionals must give the matter considerable thought before implementing school-based physical activity interventions. Given the heterogeneity of effects, the risk of bias, and findings that the magnitude of effect is generally small, results should be interpreted cautiously.
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Affiliation(s)
| | - Hilary Caldwell
- Department of Kinesiology, Child Health & Exercise Medicine Program, McMaster University, Hamilton, Canada
| | - Maureen Dobbins
- School of Nursing, McMaster University, Hamilton, Canada
- National Collaborating Centre for Methods and Tools, Hamilton, Canada
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Schulze C, Bucksch J, Demetriou Y, Emmerling S, Linder S, Reimers AK. Considering sex/gender in interventions to promote children’s and adolescents’ leisure-time physical activity: a systematic review and meta-analysis. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01625-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Abstract
Aim
The main objectives of this systematic review were to evaluate the effects of interventions on leisure-time PA of boys and girls and to appraise the extent to which studies have taken sex/gender into account.
Subject and methods
PRISMA guidelines were followed. Two researchers independently screened studies for eligibility and assessed the risk of bias. Descriptive analyses were conducted to evaluate intervention effects in relation to the consideration of sex/gender in the studies based on a newly developed checklist. Additionally, meta-analyses were performed to determine the effect of interventions on girls’ and boys’ leisure-time PA.
Results
Overall 31 unique studies reported 44 outcomes on leisure-time PA and 20,088 participants were included in the current study. Consideration of sex/gender aspects in studies is low. PA outcomes with statistically significant same/similar effects in boys and girls showed higher quality of reporting sex/gender aspects of theoretical and/or conceptual linkages with sex/gender, measurement instruments, intervention delivery, location and interventionists and participant flow than PA outcomes without significant effects in both boys and girls or effects only in boys or girls. Interventions had a small but significant effect on girls (number of included studies (k) = 9, g = 0.220, p = .003) and boys (k = 7, g = 0.193, p = .020) leisure-time PA.
Conclusion
Higher reporting of sex/gender aspects may improve leisure-time PA of boys and girls. Nevertheless, there remains a need to address sufficient consideration of sex/gender aspects in interventions in the context of PA.
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Kobes A, Kretschmer T, Timmerman G, Schreuder P. Interventions aimed at preventing and reducing overweight/obesity among children and adolescents: a meta-synthesis. Obes Rev 2018; 19:1065-1079. [PMID: 29671938 DOI: 10.1111/obr.12688] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/13/2018] [Accepted: 02/20/2018] [Indexed: 12/30/2022]
Abstract
The prevalence of child and adolescent obesity has been a major worldwide problem for decades. To stop the number of youth with overweight/obesity from increasing, numerous interventions focusing on improving children's weight status have been implemented. The growing body of research on weight-related interventions for youth has been summarized by several meta-analyses aiming to provide an overview of the effectiveness of interventions. Yet, the number of meta-analyses is expanding so quickly and overall results differ, making a comprehensive synopsis of the literature difficult. To tackle this problem, a meta-synthesis was conducted to draw informed conclusions about the state of the effectiveness of interventions targeting child and adolescent overweight. The results of the quantitative synthesis of 26 meta-analyses resulted in a standardized mean difference (SMD) of -0.12 (95%CI: -0.16, -0.08). Several moderator analyses showed that participant and intervention characteristics had little impact on the overall effect size. However, a moderator analysis distinguishing between obesity treatment and obesity prevention studies showed that obesity treatment interventions (SMD: -0.048, 95%CI: -0.60, -0.36) were significantly more effective in reducing body mass index than obesity prevention interventions (SMD: -0.08, 95%CI: -0.11, -0.06). Overall, the results of this meta-synthesis suggest that interventions result in statistically significant effects albeit of relatively little clinical relevance.
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Affiliation(s)
- A Kobes
- Department of Pedagogy and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - T Kretschmer
- Department of Pedagogy and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - G Timmerman
- Department of Pedagogy and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
| | - P Schreuder
- Department of Pedagogy and Educational Sciences, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, the Netherlands
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Owen MB, Curry WB, Kerner C, Newson L, Fairclough SJ. The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis. Prev Med 2017; 105:237-249. [PMID: 28964852 DOI: 10.1016/j.ypmed.2017.09.018] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/13/2017] [Accepted: 09/24/2017] [Indexed: 12/15/2022]
Abstract
Physical activity (PA) decreases during the transition from childhood to adolescence, with larger declines observed in girls. School-based interventions are considered the most promising approach for increasing adolescents' PA levels although, it is unclear which types of school-based interventions have the greatest impact. The objective of this systematic review is to assess the impact and design of school-based PA interventions targeting adolescent girls. A systematic search was conducted using four electronic databases (PubMed, Web of Science, SPORTDiscus and PsychInfo). This systematic review was registered with PROSPERO (Registration number: CRD42016037428) and PRISMA guidelines (2009) were followed throughout. Twenty studies were identified as meeting the inclusion criteria and were included in a narrative synthesis. Seventeen studies were eligible for inclusion in a meta-analysis. There was a significant small positive treatment effect for school-based PA interventions for adolescent girls (k=17, g=0.37, p<0.05). After an outlier was removed (residual z=7.61) the average treatment effect was significantly reduced, indicating a very small positive effect (k=16, g=0.07, p=0.05). Subgroup analysis revealed very small significant effects for multi-component interventions (k=7, g=0.09, p<0.05), interventions underpinned by theory (k=12, g=0.07, p<0.05), and studies with a higher risk of bias (k=13, g=0.09, p<0.05). Intervention effects were very small which indicates that changing PA behaviors in adolescent girls through school-based interventions is challenging. Multi-component interventions and interventions underpinned by theory may be the most effective approaches to positively change adolescent girls' PA.
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Affiliation(s)
- Michael B Owen
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, Lancashire, UK.
| | - Whitney B Curry
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, Lancashire, UK
| | | | - Lisa Newson
- Natural Sciences and Psychology, Research Centre for Brain and Behaviour, Liverpool John Moores University, Liverpool, UK
| | - Stuart J Fairclough
- Physical Activity and Health Research Group, Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, Lancashire, UK; Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland
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Minatto G, Barbosa Filho VC, Berria J, Petroski EL. School-Based Interventions to Improve Cardiorespiratory Fitness in Adolescents: Systematic Review with Meta-analysis. Sports Med 2017; 46:1273-92. [PMID: 26846429 DOI: 10.1007/s40279-016-0480-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND School-based intervention can contribute to the promotion of cardiorespiratory fitness (CRF) in adolescents. However, it is neces sary to systematize how intervention strategies and the methodological characteristics of studies influence the effects of CRF interventions. OBJECTIVE A meta-analysis review of school-based intervention studies aimed at increasing CRF in adolescents (10-19 years of age) was conducted. METHODS A search for studies was conducted using the Medline, Web of Science, LILACS, PsycINFO, Embase, Scopus, SPORTDiscus and Cochrane databases and the reference lists of the selected studies. The peer selection process included consideration of school-based randomized or non-randomized controlled trials with a duration ≥12 weeks published in English, Portuguese or Spanish, and with some CRF measures. The methodological quality of the studies was also assessed. The standardized mean differences (SMDs) and 95 % confidence intervals (95 % CIs) were calculated as an effect measure. RESULTS Forty publications of 30 interventions were included in the review, and 25 of these were meta-analysed. The effects of CRF interventions were moderate and significant (SMD = 0.68, 95 % CI 0.45-0.90), with high heterogeneity (I (2) = 97 %). The effect size varied significantly according to the age group, sample size, intervention environment, strategies in experimental groups, CRF priority in the study, CRF test and indicator, session length, weekly frequency, intervention duration and presentation of results by sex. CONCLUSION Interventions in the school environment seem to have a positive effect on CRF among adolescents, but there is high heterogeneity between studies. Some intervention characteristics can explain better effects on CRF (e.g. exercise sessions in addition to physical education classes; primary focus on this outcome; combination of aerobic and resistance exercises; classes lasting ≥60 min; frequency of three times weekly; and intensity control).
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Affiliation(s)
- Giseli Minatto
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil.
| | - Valter Cordeiro Barbosa Filho
- Research Centre for Physical Activity and Health, Sports Centre, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Juliane Berria
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil
| | - Edio Luiz Petroski
- Research Centre for Kinanthropometry and Human Performance, Sports Centre, Campus Universitário, Federal University of Santa Catarina, Trindade, Caixa Postal 476, Florianópolis, SC, CEP 88040-900, Brazil
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Wang Y, Cai L, Wu Y, Wilson RF, Weston C, Fawole O, Bleich SN, Cheskin LJ, Showell NN, Lau BD, Chiu DT, Zhang A, Segal J. What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obes Rev 2015; 16:547-65. [PMID: 25893796 PMCID: PMC4561621 DOI: 10.1111/obr.12277] [Citation(s) in RCA: 366] [Impact Index Per Article: 40.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 01/28/2023]
Abstract
Previous reviews of childhood obesity prevention have focused largely on schools and findings have been inconsistent. Funded by the US Agency for Healthcare Research and Quality (AHRQ) and the National Institutes of Health, we systematically evaluated the effectiveness of childhood obesity prevention programmes conducted in high-income countries and implemented in various settings. We searched MEDLINE®, Embase, PsycINFO, CINAHL®, ClinicalTrials.gov and the Cochrane Library from inception through 22 April 2013 for relevant studies, including randomized controlled trials, quasi-experimental studies and natural experiments, targeting diet, physical activity or both, and conducted in children aged 2-18 in high-income countries. Two reviewers independently abstracted the data. The strength of evidence (SOE) supporting interventions was graded for each study setting (e.g. home, school). Meta-analyses were performed on studies judged sufficiently similar and appropriate to pool using random effect models. This paper reported our findings on various adiposity-related outcomes. We identified 147 articles (139 intervention studies) of which 115 studies were primarily school based, although other settings could have been involved. Most were conducted in the United States and within the past decade. SOE was high for physical activity-only interventions delivered in schools with home involvement or combined diet-physical activity interventions delivered in schools with both home and community components. SOE was moderate for school-based interventions targeting either diet or physical activity, combined interventions delivered in schools with home or community components or combined interventions delivered in the community with a school component. SOE was low for combined interventions in childcare or home settings. Evidence was insufficient for other interventions. In conclusion, at least moderately strong evidence supports the effectiveness of school-based interventions for preventing childhood obesity. More research is needed to evaluate programmes in other settings or of other design types, especially environmental, policy and consumer health informatics-oriented interventions.
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Affiliation(s)
- Y Wang
- Department of Epidemiology and Environmental Health (formerly the Department of Social and Preventive Medicine), School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - L Cai
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Y Wu
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - R F Wilson
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - C Weston
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - O Fawole
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - S N Bleich
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - L J Cheskin
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - N N Showell
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - B D Lau
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D T Chiu
- Johns Hopkins Global Center on Childhood Obesity, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - A Zhang
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - J Segal
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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McGoey T, Root Z, Bruner MW, Law B. Evaluation of physical activity interventions in youth via the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: A systematic review of randomised and non-randomised trials. Prev Med 2015; 76:58-67. [PMID: 25900802 DOI: 10.1016/j.ypmed.2015.04.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/07/2015] [Accepted: 04/13/2015] [Indexed: 11/18/2022]
Abstract
CONTEXT An identified limitation of existing reviews of physical activity interventions in school-aged youth is the lack of reporting on issues related to the translatability of the research into health promotion practice. OBJECTIVE This review used the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance framework to determine the extent to which intervention studies promoting physical activity in youth report on factors that inform generalizability across settings and populations. METHODS AND RESULTS A systematic search for controlled interventions conducted within the last ten years identified 50 studies that met the selection criteria. Based on Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance criteria, most of these studies focused on statistically significant findings and internal validity rather than on issues of external validity. Due to this lack of information, it is difficult to determine whether or not reportedly successful interventions are feasible and sustainable in an uncontrolled, real-world setting. CONCLUSIONS Areas requiring further research include costs associated with recruitment and implementation, adoption rate, and representativeness of participants and settings. This review adds data to support recommendations that interventions promoting physical activity in youth should include assessment of adoption and implementation issues.
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Affiliation(s)
- Tara McGoey
- Schulich School of Education, Nipissing University, 100 College Drive, North Bay, ON P1B 8L7, Canada.
| | - Zach Root
- Schulich School of Education, Nipissing University, 100 College Drive, North Bay, ON P1B 8L7, Canada.
| | - Mark W Bruner
- Schulich School of Education, Nipissing University, 100 College Drive, North Bay, ON P1B 8L7, Canada.
| | - Barbi Law
- Schulich School of Education, Nipissing University, 100 College Drive, North Bay, ON P1B 8L7, Canada.
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Pearson N, Braithwaite R, Biddle SJH. The effectiveness of interventions to increase physical activity among adolescent girls: a meta-analysis. Acad Pediatr 2015; 15:9-18. [PMID: 25441655 DOI: 10.1016/j.acap.2014.08.009] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/22/2014] [Accepted: 08/25/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research has shown that a clear decline in physical activity among girls starting in early adolescence. Therefore, adolescent girls have been identified as a key target population for physical activity behavior change. The quantification of intervention effectiveness for this group has not been previously reported in a meta-analysis, and this therefore was the objective of the current meta-analysis. STUDY SELECTION Included were interventions in which the main component, or 1 of the components, was aimed at promoting physical activity through behavior change in any setting. Interventions had to include a non-physical activity control group or comparison group, and include a quantitative outcome assessment of physical activity behavior in girls aged 12 to 18 years. DATA SOURCES Science Direct, PubMed, PsychINFO, Web of Science, Cochrane Libraries, and EPPI Centre databases were searched up to and including May 2013. DATA EXTRACTION AND SYNTHESIS Forty-five studies (k = 34 independent samples) were eligible from an initial 13,747 references. A random-effects meta-analysis was conducted. RESULTS The average treatment effect for adolescent girls involved in physical activity interventions was significant but small (g = 0.350, 95% confidence interval 0.12, 0.58, P < .001). Moderator analyses showed larger effects for interventions that were theory based, performed in schools, were girls only, with younger girls, used multicomponent strategies, and involved targeting both physical activity and sedentary behavior. CONCLUSIONS Interventions to increase physical activity in adolescent girls show small but significant effects, suggesting that behavior change may be challenging. Results suggest some approaches that appear to be successful.
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Affiliation(s)
- Natalie Pearson
- School of Sport, Exercise & Health Sciences, Loughborough University, UK
| | - Rock Braithwaite
- Department of Kinesiology and Recreation Administration, Humboldt State University, Arcata, Calif
| | - Stuart J H Biddle
- School of Sport, Exercise & Health Sciences, Loughborough University, UK; NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, UK.
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Lai SK, Costigan SA, Morgan PJ, Lubans DR, Stodden DF, Salmon J, Barnett LM. Do School-Based Interventions Focusing on Physical Activity, Fitness, or Fundamental Movement Skill Competency Produce a Sustained Impact in These Outcomes in Children and Adolescents? A Systematic Review of Follow-Up Studies. Sports Med 2013; 44:67-79. [PMID: 24122775 DOI: 10.1007/s40279-013-0099-9] [Citation(s) in RCA: 149] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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