Effect of classroom-based physical activity interventions on academic and physical activity outcomes: a systematic review and meta-analysis

How does a school-based intervention impact students' social cognitions on reducing sedentary behavior over 14 months?

Despite sedentary behavior being ubiquitous in students and detrimental to health, interventions specifically targeting it are mostly restricted to leisure time screen time reduction. With six weekly sessions alongside a poster campaign and an additional teacher intervention, the Let's Move It trial delivered environmental and psychological strategies to increase physical activity (PA) and reduce sedentary behavior (SB) in vocational schools, an understudied environment for behavioral interventions. Participants in the intervention arm considerably reduced sedentary time post-intervention. To investigate how social cognitions about restricting SB, as defined by the Reasoned Action Approach, change in intervention and control arms, self-reported data on social cognitions was collected as part of a cluster-randomized controlled trial from 1166 students (59% female, mage = 18.7 years, range: 16-49) in six vocational schools before, post-intervention, and 14 months post-baseline. Data were analyzed using mixed between-within repeated measures ANOVA. We found greater improvements in intention (F(1, 833) = 9.69; η2p = 0.01; p = .018) and descriptive norms (F(1, 831) = 13.25; η2p = 0.016; p < .001) in the intervention than control arm, but these effects depended on the included control variables. Generally, intervention effects leveled off from post-intervention to follow-up. The Let's Move It intervention for SB reduction showed modest, short-lived effects on social cognitions, indicating that changes in behavior are likely due to other factors like changes to the classroom environment. Optimally, SB reduction interventions should not only change behavior but produce robust changes in conscious intentions to restrict one's sitting, so that positive effects generalize to other contexts.

Effectiveness of Participatory Research Interventions on Obesity and Obesity-Related Behaviors in Adolescents: A Systematic Review and Meta-analysis

CONTEXT

Adolescence is an optimal period to promote healthy lifestyles because behavior patterns are established in this stage. It has been suggested that engaging youth increases the effectiveness of interventions, but an overview is lacking.

OBJECTIVE

This study aims to evaluate the effectiveness of participatory research (PR) interventions, where adolescents (11-18 years old) from high-income countries had a significant role in the intervention development and/or delivery, compared with no (PR) intervention control groups on obesity-related outcomes and healthy lifestyle behaviors (HLBs).

DATA SOURCES

Eight databases (Embase, Medline ALL, Web of Science Core Collection, PsycINFO, ERIC, CINAHL, Scopus, and Cochrane Central Register of Controlled Trials) and Google Scholar were searched from 1990 to 2024 for randomized controlled trials (RCTs) and non-RCTs (in English).

DATA EXTRACTION

Two researchers independently performed the data extraction and risk-of-bias assessment.

DATA ANALYSIS

Sixteen studies were included and outcomes have been narratively described. Seven studies evaluated youth-led interventions, 3 studies evaluated co-created interventions, and 6 studies evaluated the combination of both. Six studies focused on physical activity (PA), 2 on nutrition, and 8 on a combination of PA, nutrition, and/or obesity-related outcomes. Ten studies presented at least 1 significant effect on PA, nutrition, or obesity-related outcomes in favor of the intervention group. Additionally, 12 studies were pooled in a meta-analysis. Whereas a small desired effect was found for fruit consumption, a small undesired effect was found for vegetable consumption. The pooled analysis found no significant effects on moderate-vigorous PA, total PA, and PA self-efficacy.

CONCLUSION

We found some evidence that youth empowerment in research may have positive effects on obesity-related HLBs, specifically an increased fruit consumption. However, the overall evidence was inconclusive due to limited studies and the heterogeneity of the studies included. This overview may guide future public health interventions that aim to engage and empower adolescents.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration Nº CRD42021254135.

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.

Exploring the mediating role of promoting school physical activity on the relationship between low socioeconomic status and academic achievement and school climate: evidence from 4,990 Chilean schools

There is evidence that promoting school physical activity (PSPA) benefits children and adolescents, but little is understood about how this promotion may relate to academic achievement and school climate across varying levels of socioeconomic status (SES). Hence, the study aimed to address this knowledge gap by examining two main objectives: (1) determining the association between PSPA and academic achievement and school climate according to schools' SES and (2) exploring the potential mediating role of PSPA in the relationship between schools' SES and academic achievement and school climate. This cross-sectional study at the school level focused on 4,990 schools (including public, subsidized, and private schools) that participated in the National Educational Study 2018 (Chile), which was applied to primary schoolchildren (4th grade, aged 8-10 years). Schools were divided into non-PSPA (n = 4,280) and PSPA (n = 710) during the year 2018. Changes in academic achievement from 2017 to 2018 and school climate were considered. PSPA was associated with improvements in maths (low-SES OR: 1.80, p < 0.001) and reading (middle-SES OR: 1.45, p = 0.029; low-SES OR: 1.47, p < 0.001). The indirect effect (IE) showed that PSPA partially mediated the relationship between SES and academic achievement in reading (IE = 1.017; SE = 0.12; 95%CI, -1.27, -0.77), maths (IE = -1.019; SE = 0.12; 95%CI, -1.25, -0.78), and school climate (IE = -0.46; SE = 0.52; 95%CI, -0.56, -0.35). In conclusion, PSPA was linked to positive changes in academic achievement, especially among low SES, and PSPA presented a potential mediating role in the relationship between SES of schools and academic achievement and school climate.

Preliminary Program Evaluation of Pocket PE 3-5™, A User-Friendly Digital Application for Teacher Skills Training and Physical Education Activities for Third- to Fifth-Grade Elementary Students

BACKGROUND

In the United States, many classroom teachers also teach physical education (PE). However, there is a dearth of evidence- and standard-based PE programs designed to support classroom teachers to deliver PE effectively in schools.

METHODS

The purpose of this study was to establish proof-of-concept for the Pocket PE 3-5 digital app in school settings with 10 third- to fifth-grade classroom teachers. We assessed fidelity of program implementation, measured via observations of PE quality. Students used wrist-worn heart rate monitors during Pocket PE 3-5 lessons to measure time spent in moderate to vigorous physical activity. Program feasibility was primarily assessed through teacher-reported surveys of usability, satisfaction, and acceptability and exit interviews.

RESULTS

Mean PE observation scores were 18.6 (SD = 1.5) on a scale of 5 to 20. On average, students spent 56.7% (SD = 13.1%) of class time engaging in moderate to vigorous physical activity. Mean survey scores, reported on a 5-point scale, were 4.5 (SD = 0.6) for acceptability, 4.8 (SD = 0.4) for usability, and 4.7 (SD = 0.7) for satisfaction. Teachers liked how easy the app was to use but mentioned some technological challenges.

CONCLUSIONS

This program evaluation study established the proof-of-concept for the Pocket PE 3-5 elementary school PE program.

PROTOCOL: Key characteristics of effective preschool-based interventions to promote self-regulation: A systematic review and meta-analysis

This is the protocol for a Cochrane Review. The objectives are as follows: The aim of this systematic review is to advance our understanding of the key characteristics of effective preschool-based interventions designed to foster self-regulation. To accomplish this, the review addresses the following questions: 1. What types of preschool-based interventions have been developed to promote self-regulation? 2. What is the average effect of these preschool-based interventions on self-regulation, focusing on four key constructs: integrative effortful control, integrative executive function, self-regulation, and self-regulated learning? 3. What characteristics-such as Resource Allocation, Activity Type, and Instruction Method-could potentially contribute to the effects of preschool-based interventions in promoting self-regulation?

Examining associations between physical activity context and children meeting daily physical activity guidelines: the role of outdoor play, sports, and other organized activities

Background

Less than one-quarter of US children meet physical activity (PA) guidelines. Understanding the context in which PA occurs and how these contexts may play a role in meeting PA guidelines is an essential step toward developing effective behavioral interventions. The purpose of this study was to examine associations between PA context (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines in a representative sample of children living in Texas.

Methods

We analyzed cross-sectional data from a statewide sample of fourth-grade children in Texas who completed the 2019-2020 Texas School Physical Activity and Nutrition (Texas SPAN) survey. The Texas SPAN survey was designed to monitor the statewide prevalence of overweight/obesity among school children and assess habitual self-reported obesity-related behaviors, including diet and PA. Weighted Poisson regression models were employed to examine the associations between PA contexts (sports participation, participation in other organized physical activities, active travel to school, and outdoor play) and the number of days children met PA guidelines, adjusting for sex, race/ethnicity, overweight/obesity, urban-rural status, and economic disadvantage.

Results

A total of 16.7% of fourth-grade children met physical activity guidelines every day during the week (mean age = 9.4 ± 0.6 years; female = 48.7, 51.8% Hispanic, mean days meeting PA guideline = 3.6 ± 2.3 days). One in ten (11.2%) children did not meet daily PA guidelines on any day of the week, and 72.1% met them between 1 and 6 days. Participating in sports (b = 0.22, 95%CI:0.14, 0.30), any other organized physical activities (b=0.13, 95%CI:0.017, 0.19), and playing outdoors 1-3 days (b = 0.25, 95%CI:0.04, 0.46) and 4-7 days in the past week (b = 0.77, 95%CI:0.57, 0.97) was significantly and positively associated with the number of days children met PA guidelines.

Conclusion

Participating in sports, participating in other organized physical activities, and playing outdoors may beneficially influence the number of days children meet PA guidelines. PA programs should consider these contextual factors and investigate how to promote organized activities and outdoor play effectively and appropriately among children.

Is adherence to the 24-h movement guidelines associated with greater academic-related outcomes in children and adolescents? A systematic review and meta-analysis

The purpose of this systematic review was to synthesise the evidence for the association of adherence to the 24-h movement guidelines with academic-related outcomes in children and adolescents. This systematic review was based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. PubMed, PsycINFO, Scopus, WOS, SPORTDiscus, and EMBASE were searched from their inception to 12 December 2023. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess the risk of bias of included studies. In total, 4326 records were identified through database searches; 10 articles met the inclusion criteria and were included in this systematic review. There were eight cross-sectional studies and two longitudinal studies; the main academic-related outcomes were academic achievement and cognitive function. A small association between adherence to all three recommendations and academic achievement (k = 5, r = 0.17, 95% CI = 0.10-0.24, I2 = 49%) was found compared to those who did not adhere to any recommendations.   Conclusion: Findings from this systematic review and meta-analysis reveal a small association between adherence to all three recommendations and greater academic achievement in children and adolescents. Nevertheless, it is imperative to underscore the need for more studies to establish robust evidence underpinning this relationship.   Trial registration: PROSPERO (CRD42021295403). What is Known: • Regular physical activity, reduced screen time, and optimal sleep duration are independently associated with improved academic-related outcomes in children and adolescents. • The associations between adherence to the 24-h movement guidelines and academic-related outcomes in children and adolescents have not been quantitatively synthesised. What is New: • There is a small but positive association between adherence to all three recommendations of the 24-h movement guidelines and greater academic achievement in children and adolescents. • Further well-designed research is needed to focus on academic achievement, cognitive function and classroom behaviours in young individuals.

Physical Activity, Confidence, and Social Norms Associated With Teachers' Classroom Physical Activity Break Implementation

Despite the benefits of classroom physical activity breaks on student health and academic outcomes, more research is needed to understand what factors may be associated with classroom physical activity break implementation, to bolster buy-in from school stakeholders and increase implementation. This quantitative study examined frequency of classroom physical activity break implementation in relation to (1) objectively measured teachers' physical activity and sedentary behaviors, (2) confidence for leading classroom physical activity breaks, (3) social norms (perceptions of other teachers' classroom physical activity break implementation), and (4) teacher- and school-level demographics. In total, 153 classroom teachers in 20 elementary and middle schools completed a survey including classroom physical activity break frequency, confidence, and social norms, one item each, dichotomized (1 = "most/all the time" OR "agree/strongly agree"). Accelerometry assessed total activity and daytime sedentary behavior. Analyses included multilevel binary logistic regression. Teachers were 90% female, 68% White, and 55% in elementary schools. Odds of implementing classroom physical activity breaks were lower among middle school teachers, 14 times greater among those with greater confidence, and over 17 times greater when teachers perceived others frequently implementing classroom physical activity breaks. Teacher activity was not associated with classroom physical activity break implementation. Future interventions to increase classroom physical activity break implementation should focus on increasing teachers' confidence to lead classroom physical activity breaks and creating more buy-in from classroom teachers to enhance each school's culture of health. By enhancing teacher confidence and social norms for implementing classroom physical activity breaks, we may increase school-based physical activity opportunities.

In-classroom physical activity breaks program among school children in Sri Lanka: study protocol for a randomized controlled trial

Background

The problem of sedentary behavior among primary school children is alarming, with numbers gradually increasing worldwide, including Sri Lanka. Physical activity interventions within classroom settings have been acknowledged as a critical strategy to increase students' movement behaviors while enhancing their academic achievement and health. Yet, the busy curriculum and challenging educational demands encourage more sedentary classroom behavior. Hence, this study aims to develop and evaluate an in-classroom physical activity breaks (IcPAB) intervention among fifth graders in Sri Lanka.

Methods

The study will adopt a randomized controlled trial (RCT), comprising an in-classroom physical activity breaks program group and a control group to evaluate the effects of IcPAB on academic achievement, movement behaviors and health outcomes. The intervention design is based on the capability (C), opportunity (O) and motivation (M) behavior (B) (COM-B) model. A least 198 fifth graders will be recruited from two schools in Uva province, Sri Lanka. The recruitment process will start in late 2022. Class teachers of the intervention group will implement 5-min activity breaks at least three times a day after completing a training session. The primary variables include mathematics and reading achievement. The secondary variables include physical activity levels, steps count, sedentary behavior, body mass index, aerobic fitness, and perceived stress. Data collection will be implemented at pre-test and post-test, respectively. Intervention fidelity and the process will also be evaluated.

Discussion

The IcPAB is designed to prevent pure educational time loss by introducing curriculum-integrated short bouts of physical active breaks into the classroom routine. If the IcPAB is effective, it can (1) improve the mathematics and reading achievement of fifth-grade girls and boys, which is a significant factor determining the performance at the Grade Five National Scholarship Examination in Sri Lanka; (2) improve movement behaviors as well as physical and mental health outcomes among primary school students. Sequentially, the IcPAB will enrich school-based physical activity intervention approaches which can in turn bring academic and health benefits to primary school children in Sri Lanka.

Trial registration

The first version of the trial was registered with the ISRCTN registry (Ref: ISRCTN52180050) on 20/07/2022.

The association between health behaviours and academic performance moderated by trait mindfulness amongst university students: an observational study

Objectives

To target health communication at less health-conscious groups, evidence on health behaviours' effects on non-health-related outcomes - such as academic performance - is necessary. Recent research has highlighted the associations of various health behaviours on academic performance of university students. However, there is a lack of research investigating the most predominant health behaviours simultaneously and their association with academic performance, as well as the factors that potentially influence the direction or strength of these associations. Therefore, this study investigated (I) which of the predominant health behaviours (physical activity, healthy diet, sleep, sedentary behaviour, alcohol consumption, smoking, drug use) are most associated with academic performance and (II) whether the personal resource of trait mindfulness moderates these associations.

Methods

An online survey was conducted amongst university students during the 2021 summer semester. Group differences in academic performance regarding health behaviours were analysed using ANOVA (N = 1,049). A first linear regression model (N = 571), considering all selected health behaviours simultaneously, assessed their association with academic performance. A second model (N = 540) assessed interaction effects of health behaviours and trait mindfulness. Separate regressions assessed each interaction's association with academic performance.

Results

Sleep, fruit and vegetable consumption, and gender were significantly associated with academic performance. The second model showed no significant interaction effects.

Conclusion

Targeting sleep and fruit and vegetable consumption might be the most promising strategies for elevating students' academic performance, thereby enabling health communication strategies to reach groups driven by performance improvements rather than health benefits.

'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.

Effect of classroom-based physical activity on teaching quality of systemic lupus erythematosus for medical undergraduates

OBJECTIVE

To explore the influence of classroom-based physical activity (CB-PA) on the teaching quality of systemic lupus erythematosus (SLE) for medical undergraduates.

METHODS

Students from 8 classes participating in the clinical medicine program of the affiliated hospital of Zunyi Medical University were divided into two groups. Four classes received regular teaching on the SLE chapter as the control group, and the other four received CB-PA intervention as the experimental group. After class, the basic ability (diagnostics and pharmacology scores in sophomore year) and teaching quality scores were collected and compared using a questionnaire. The performance of the 2 groups to the SLE review questions was compared.

RESULTS

The scores of learning interest, the degree of satisfaction with the courses, and the level of mastering the teaching contents in the experimental group were significantly higher than those in the control group. The evaluation of the teacher's teaching level increased considerably. The experimental group's performance was also better than the control group's (the assessment performance was adjusted with the basic ability).

CONCLUSION

CB-PA in teaching SLE improves students' interest in learning, teaching satisfaction, and mastery of knowledge and may ultimately enhance their assessment results.

Effectiveness of the Walking in ScHools (WISH) Study, a peer-led walking intervention for adolescent girls: results of a cluster randomised controlled trial

BACKGROUND

Most adolescent girls fail to meet current physical activity guidelines. Physical activity behaviours track from childhood into adulthood and providing adolescent girls with opportunities to be physically active may have health benefits beyond childhood. The effects of walking interventions on adult cardiometabolic health are known, however less is understood about the potential of walking to promote physical activity in adolescents. Following the Walking In ScHools (WISH) feasibility study, this definitive trial aimed to evaluate the effectiveness of a novel, low-cost, school-based walking intervention at increasing physical activity levels of adolescent girls (aged 12-14 years).

METHODS

Female pupils were recruited from eighteen schools across the border region of Ireland and in Northern Ireland. In intervention schools (n = 9), girls aged 15-18 years, were trained as walk leaders, and led the younger pupils in 10-15 min walks before school, at break and lunch recess. All walks took place in school grounds and pupils were encouraged to participate in as many walks as possible each week. The primary outcome measure was accelerometer determined total physical activity (counts per minutes, cpm).

RESULTS

In total, 589 pupils were recruited to the study. At baseline, pupils engaged in a median (interquartile range (IQR)) 35.7 (21.2) mins moderate-vigorous physical activity (MVPA) per day and only 12% (n = 66) of participants met physical activity guidelines (60 min MVPA per day). The intervention was delivered for a mean (standard deviation (SD)) 19.9 ± 0.97 weeks. The mean post-intervention total physical activity for the intervention group was 676 cpm and 710 cpm in the control group. Post-intervention total physical activity did not statistically differ between groups when adjusted for age, body mass index z-scores and baseline physical activity (mean difference, -33.5, 95% CI = -21.2 to 88.1; p = 0.213).

CONCLUSIONS

'Scaling-up' physical activity interventions is challenging and despite a promising feasibility study, the results of this fully powered trial suggest that in this context, the WISH intervention did not increase device measured physical activity. Since the COVID-19 pandemic, school environments have changed and although pupils enjoyed the programme, attendance at walks was low, indicating that there is a need to better understand how to implement interventions within schools.

TRIAL REGISTRATION

ISRCTN; ISRCTN12847782; Registered 2nd July 2019.

Physical activity interventions in European primary schools: a scoping review to create a framework for the design of tailored interventions in European countries

Introduction

Schools provide a unique environment to facilitate physical activity for children. However, many school-based physical activity interventions have not been effective. We propose a new approach, which allows schools to tailor interventions to their specific context. This scoping review aimed to identify intervention components from previous school-based physical activity interventions to form the basis of a tailored approach in a European setting.

Methods

Joanna Briggs Institute guidelines for conducting scoping reviews were followed. European school-based intervention studies aimed at increasing physical activity in children aged 7-11 years published in English since 2015 were included. Databases searched were Ovid Medline, Embase, PsycINFO, Web of Science Social Sciences Citation Index, ERIC and British Education Index. Data was extracted on intervention components, context-related factors (geographical location, school size, child socioeconomic status and ethnicity), feasibility, acceptability and cost-effectiveness. A data-driven framework was developed to summarize the identified intervention components.

Results

79 articles were included, constituting 45 intervention studies. We identified 177 intervention components, which were synthesized into a framework of 60 intervention component types across 11 activity opportunities: six within the school day, three within the extended school day and two within the wider school environment. Interventions most frequently targeted physical education (21%), active and outdoor learning (16%), active breaks (15%), and school-level environmewnt (12%). Of the intervention components, 41% were delivered by school staff, 31% by the research team, and 24% by external organizations. Only 19% of intervention studies reported geographical location and only 10% reported school size. Participant ethnicity and socioeconomic information was reported by 15% and 25%, respectively. Intervention acceptability was reported in 51% of studies, feasibility in 49%, and cost effectiveness in 2%.

Discussion

This review offers a first step in developing a future framework to help schools to develop context-specific, tailored interventions. However, there was a lack of reporting of contextual factors within the included studies, making it difficult to understand the role of context. Future research should seek to measure and report contextual factors, and to better understand the important aspects of context within school-based physical activity.

The effects of proprioceptive exercise training on physical fitness and performance of soccer skills in young soccer players

The purpose of this study is to analyze the effect of proprioceptive exercise training on soccer skills and physical fitness in young soccer players. Nineteen young soccer players participated in the study. Participants were divided into proprioceptive exercises training (PT) and control (Cont) groups. The physical fitness and soccer skill performance test assessed at pre- and posttraining. Balance ability and power significantly improved in both groups after 8 weeks of training (P<0.05). Dribble in the PT group was similar between pre- and posttraining, with a statistically significant difference in the Cont group (P<0.05). There were no significant differences within and between groups according to training in the left and right feet for juggling. The PT and Cont groups did not differ significantly regarding short passes posttraining. However, a significant improvement in long passes was observed in the PT group after training period (P<0.05). Shooting was no different between and within the groups. In conclusion, these inconsistent findings are thought to be due to the applied exercise method, training duration, and the specificity of the physical growth period of the young players. Therefore, it is necessary to increase the frequency and time of proprioceptive exercise training and apply factors for cognitive ability improvement to training programs for young soccer players in future studies. These studies could suggest appropriate training methods necessary to improve the performance of young soccer players.

The physical and psychosocial impact of a school-based running programme for adolescents with disabilities

BACKGROUND

Adolescents with disabilities have fewer opportunities to participate in community-based fitness programmes. The purpose of this study was to examine the impact of a school-based running programme at a local middle school in Lebanon, Pennsylvania, on fitness and quality of life (QoL) in children with physical and cognitive disabilities in a life-skills classroom.

METHODS

Nineteen adolescents with diagnosed disabilities including intellectual disability (ID), autism spectrum disorder and Down syndrome were recruited from three life-skills classrooms to participate in a school-based running programme. The programme was designed to be implemented two times/week for 6 weeks by classroom teachers/aides. Physical therapy faculty and students developed the programme and assisted with implementation. Each session lasted 30 min, consisting of a warm-up and cooldown, relay races, games and timed runs. Pre- and post-test measures included physiological cost index (PCI) and Paediatric Quality of Life Inventory™ (PedsQL™). Pre- and post-test data were compared using Wilcoxon signed rank tests. Each week participants also completed a training log to reflect on the activity for the day.

RESULTS

Participants demonstrated significant improvements in PCI (P = 0.028) and the PedsQL™ (P = 0.008) following the running programme.

CONCLUSIONS

Results of this study suggest that participation in a 6-week school-based running programme may improve fitness and QoL in adolescents with disabilities.

The relationship between ostracism and negative risk-taking behavior: the role of ego depletion and physical exercise

Background

As a major public health problem globally, negative risk-taking behavior of college students may be related to their ostracism experience, but the reason for this association is unclear. Based on the limited resource theory, combined with the integrative model of athletic performance, we tested a moderated mediation model in which ego depletion mediated the association between ostracism and risk-taking, and physical exercise moderated the mediation process to examine the mechanisms underlying the association between ostracism and negative risk-taking behavior.

Methods

One thousand three hundred seven students (43% female) from four universities in China were recruited using cluster random sampling. The experience of being ostracized, ego depletion, physical exercise level, and negative risk-taking behavior were measured through an anonymous online questionnaire in "www.sojump.com."

Results

After controlling for gender and grade in college, ostracism was positively related to negative risk-taking behavior; ego depletion mediated this relationship; and physical exercise level attenuated these direct and indirect relationships.

Conclusion

The results highlight individual risk and protective factors associated with negative risk-taking behavior, and provide new perspectives on ways to prevent and reduce college students' negative risk-taking behavior.

An active break program (ACTIVA-MENTE) at elementary schools in Chile: study protocol for a pilot cluster randomized controlled trial

Background

Physical inactivity is prevalent in childhood. Schools can be an ideal context to promote the regular practice of physical activity since children spend there a large part of the day. In this sense, an emerging and current trend is active breaks at school. This article presents a study protocol that seeks to assess the feasibility and effectiveness of an intervention with active breaks (ACTIVA-MENTE program) in a school context on physical activity, on-task classroom behavior, and the physical activity enjoyment in schoolchildren.

Methods

The protocol includes children aged 10 to 11 years. Two groups will be randomized (intervention and control groups). The intervention group will use the active break program, ACTIVA-MENTE, which consists of the application of a 4-min, 30-s video with moderate to vigorous-intensity physical activity. These breaks will be taken 6 times a day in the classes for 6 weeks. The total physical activity will be measured with accelerometers (Actigraph wGT3X-BT), the on-task behavior through the Direct Behavior Rating Scale and the level of enjoyment through the Physical Activity Enjoyment Scale.

Discussion

Previous research reported that active breaks have positive results in physical activity levels. This study will be one of the few to design active breaks through videos without depending on the presence of a physical education teacher and it can also provide new findings on the effectiveness of an active break's structure (e.g., types of exercises and intensity) on the indicated outcomes.

Expected results

It is expected that the ACTIVA-MENTE program can be a suitable program for school settings, potentially increasing physical activity levels, and the commitment to the task, as well as be a pleasant moment for the students.

Clinical trial registration

Clinicaltrials.gov, identifier NCT05403996.

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.

Acute effect of physical activity on academic outcomes in school-aged youth: A systematic review and multivariate meta-analysis

BACKGROUND

There has been an increase in the number of studies examining the effect of acute and chronic physical activity on academic outcomes in children and adolescents in the last two decades. We aimed to systematically determine the acute effects of physical activity on academic outcomes in school-aged youth and to examine possible moderators.

METHODS

We conducted a systematic search using PubMed, Web of Science, SPORTDiscus, and PsycINFO databases (from inception to 11th January 2023) for studies assessing the acute effects of physical activity on academic performance-related outcomes in school-aged youth. A univariate and multivariate meta-analysis was conducted based on a random-effects model with restricted maximum likelihood used to pool the academic outcomes results (Hedge's g).

RESULTS

We included 11 articles (803 children and adolescents [range: 6-16 years]) in the systematic review. Overall, acute physical activity increased academic outcomes (Hedge's g = 0.35, 95% CI: 0.20-0.50). Multivariate meta-analyses revealed that physical activity increased academic performance in mathematics (Hedge's g = 0.29, 95% CI: 0.16-0.42) and language (Hedge's g = 0.28, 95% CI: 0.09-0.47). Only behavior change techniques (Hedge's g = 0.54, 95% CI, 0.18-0.90, p < 0.001) played a significant role in this relationship.

CONCLUSIONS

A single bout of physical activity can improve academic outcomes in school-aged youth, which may serve as a complementary tool for the educational field. However, the observed heterogeneity in the results indicates that we should interpret the findings obtained with caution.

Integrating wellness into curricula using the ten dimensions of wellness as a framework

Burnout is a public health crisis that persists at the expense of clinician well-being, the healthcare workforce, and the quality of care provided. Clinician well-being is a professional imperative, yet nursing students still report higher levels of burnout than non-nursing students. Cultivating an academic learning environment that supports the development of resiliency, well-being, and improved student mental health requires a coordinated and sustained effort from nurse educators and academic leaders. This article aims to inspire nurse educators to take the first or next steps toward integrating wellness into nursing curricula. The ten dimensions of wellness provide a framework for wellness programming. Practical strategies aligned with each dimension are offered. As an exemplar, the Banding Together for Wellness program is summarized, including innovative incentives for student participation. Over the past five years, 426 (approximately 54 %) undergraduate nursing students voluntarily completed the program. While best practices may vary by institution, the strategies and resources offered herein can support nurse educators in the classroom, lab, and clinical setting as we all work to foster personal and professional well-being in nursing students. Nurse educators can be instrumental in cultivating the knowledge, skills, and attitudes required for life-long self-care, well-being, and nursing practice.

Student arousal, engagement, and emotion relative to Physical Education periods in school

BACKGROUND

Exercise has transient effects on cognition and mood, however the impact of Physical Education (PE) on cognitive and affective processes across the school day has not been examined.

METHOD

This study used wearables and questionnaires to track student arousal, engagement, and emotion across school days/periods following PE. Skin conductance, heart rate, heart rate variability, and self-reported engagement, arousal, and valence were analyzed for 23 students (age 15-17 years) on days with and without PE.

RESULTS

Sympathetic arousal was significantly higher for two hours following PE and there were stronger decreases in arousal across other classes relative to days without PE. On days with PE, engagement decreased, whereas valence increased from morning to afternoon.

CONCLUSION

These findings highlight the importance of considering acute effects of PE on learning across the entire school day, and demonstrates the feasibility of wearables to clarify how the timing of PE could positively or negatively affect self-regulation and learning.

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.

Effects of Resistance Training on Academic Outcomes in School-Aged Youth: A Systematic Review and Meta-Analysis

BACKGROUND

The primary aim of our systematic review and meta-analysis was to investigate the effect of resistance training on academic outcomes in school-aged youth.

METHODS

We conducted a systematic search of six electronic databases (CINAHL Complete, PsycINFO, SCOPUS, Ovid MEDLINE, SPORTDiscus and EMBASE) with no date restrictions. Studies were eligible if they: (a) included school-aged youth (5-18 years), and (b) examined the effect of resistance training on academic outcomes (i.e., cognitive function, academic achievement, and/or on-task behaviour in the classroom). Risk of bias was assessed using the appropriate Cochrane Risk of Bias Tools, funnel plots and Egger's regression asymmetry tests. A structural equation modelling approach was used to conduct the meta-analysis.

RESULTS

Fifty-three studies were included in our systematic review. Participation in resistance training (ten studies with 53 effect sizes) had a small positive effect on the overall cognitive, academic and on-task behaviours in school-aged youth (standardized mean difference (SMD) 0.19, 95% confidence interval (CI) 0.05-0.32). Resistance training was more effective (SMD 0.26, 95% CI 0.10-0.42) than concurrent training, i.e., the combination of resistance training and aerobic training (SMD 0.11, 95% CI - 0.05-0.28). An additional 43 studies (including 211 effect sizes) examined the association between muscular fitness and cognition or academic achievement, also yielding a positive relationship (SMD 0.13, 95% CI 0.10-0.16).

CONCLUSION

This review provides preliminary evidence that resistance training may improve cognitive function, academic performance, and on-task behaviours in school-aged youth.

PROSPERO REGISTRATION

CRD42020175695.

The Comprehensive School Physical Activity Program: An Invited Review

Physical inactivity is a global challenge that necessitates early intervention during childhood. Schools are positioned to make a significant impact on children's current and future physical activity behavior, but numerous barriers hinder the implementation and sustainability of school-based physical activity opportunities. The purpose of this invited article is to provide an overview of the comprehensive school physical activity program (CSPAP) as a concept, framework, and promising approach to institutionalizing physical activity within the school environment. Despite the availability of numerous published reviews on the topic, a broad, up-to-date panorama of the CSPAP literature that encompasses and consolidates historical, conceptual, empirical, and practical perspectives is currently lacking. Contained within this article is an explanation of the public health context that undergirds the CSPAP concept, a historical perspective of the concept's origins and evolution, examples of CSPAP research, recommendations for advancing the knowledge base, and evidence-informed frameworks and principles for professional practice.

Scaling up a school-based intervention to increase physical activity and reduce sedentary behaviour in children: protocol for the TransformUs hybrid effectiveness-implementation trial

INTRODUCTION

Efficacious programmes require implementation at scale to maximise their public health impact. TransformUs is an efficacious behavioural and environmental intervention for increasing primary (elementary) school children's (5-12 years) physical activity and reducing their sedentary behaviour within school and home settings. This paper describes the study protocol of a 5-year effectiveness-implementation trial to assess the scalability and effectiveness of the TransformUs programme.

METHODS AND ANALYSIS

A type II hybrid implementation-effectiveness trial, TransformUs is being disseminated to all primary schools in the state of Victoria, Australia (n=1786). Data are being collected using mixed methods at the system (state government, partner organisations), organisation (school) and individual (teacher, parent and child) levels. Evaluation is based on programme Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. RE-AIM domains are being measured using a quasi-experimental, pre/post, non-equivalent group design, at baseline, 12 and 24 months. Effectiveness will be determined in a subsample of 20 intervention schools (in Victoria) and 20 control schools (in New South Wales (NSW), Australia), at baseline, 12 and 24 months. Primary outcomes include TransformUs Reach, Adoption, Implementation and organisational Maintenance (implementation trial), and children's physical activity and sedentary time assessed using accelerometers (effectiveness trial). Secondary outcomes include average sedentary time and moderate to vigorous-intensity physical activity on weekdays and during school hours, body mass index z-scores and waist circumference (effectiveness trial). Linear mixed-effects models will be fitted to compare outcomes between intervention and control participants accounting for clustering of children within schools, confounding and random effects.

ETHICS AND DISSEMINATION

The trial was approved by the Deakin University Human Research Ethics Committee (HEAG-H 28_2017), Victorian Department of Education, the NSW Department of Education, Australian Catholic University (2017-145R), Melbourne Archdiocese Catholic Schools and Catholic Schools NSW. Partners, schools/teachers and parents will provide an informed signed consent form prior to participating. Parents will provide consent for their child to participate in the effectiveness trial. Findings will be disseminated via peer-reviewed publications, scientific conferences, summary reports to schools and our partner organisations, and will inform education policy and practice on effective and sustainable ways to promote physical activity and reduce sedentary behaviours population-wide.

TRIAL REGISTRATION NUMBER

Australian Clinical Trials Registration Registry (ACTRN12617000204347).

Are active school transport and leisure-time physical activity associated with performance and wellbeing at secondary school? A population-based study

BACKGROUND

Physically active pupils may be better and more resilient learners. However, it is unclear whether walking or cycling to school yields similar educational and school-related mental health benefits as leisure-time physical activity. We examined the associations of active school transport and leisure-time moderate-to-vigorous physical activity with perceived academic performance, competency in academic skills, school burnout and school enjoyment.

METHODS

We included 34 103 Finnish adolescents (mean age 15.4 years; 53% girls) from the 2015 School Health Promotion study cohort. For the analyses, we used logistic regression, adjusting for major sociodemographic, environmental, lifestyle and physical activity covariates.

RESULTS

Active school transport was positively associated with educational outcomes and school enjoyment, but not with school burnout. For example, compared with non-active transport, 10-30 min of daily active school transport was linked to 30% [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.21-1.40] and 17% (OR 1.17, 95% CI 1.08-1.27) higher odds of high perceived academic performance and high reading competency, respectively. Leisure-time physical activity was robustly associated with all outcomes. For example, compared with the inactive, the most physically active adolescents had 86% higher odds of high perceived academic performance (OR 1.86, 95% CI 1.66-2.08), 57% higher odds of high competency in mathematics (OR 1.57, 95% CI 1.39-1.77) and 40% lower odds of school burnout (OR 0.60, 95% CI 0.52-0.69).

CONCLUSIONS

Compared with active school transport, leisure-time physical activity was more strongly associated with educational and school-related mental health outcomes. Nevertheless, walking or cycling to school might lead to improvements in classroom performance and school enjoyment.

The effects of active classroom breaks on moderate to vigorous physical activity, behaviour and performance in a Northern NSW primary school: A quasi-experimental study

ISSUE ADDRESSED

Approximately 77% of NSW children aged 5 to 15 years do not meet physical activity guidelines and many spend a considerable amount of time sitting. Active breaks at primary school are feasible, may increase daily moderate to vigorous physical activity (MVPA) and decrease off-task behaviour without adversely affecting cognitive function and learning.

METHODS

In this quasi-experimental study, 101 primary school children in six intervention classrooms participated in three 10-minute active breaks per day for six-weeks during class time, while five control classrooms were run as usual (n = 89). Physical activity levels were measured using wrist-worn Actigraph wGT3X-BT accelerometers and analysed using a random forest model. Students' off-task behaviour, wellbeing, cognitive function and maths performance were also measured. School staff completed a brief feedback survey.

RESULTS

Children in the intervention group engaged in 15.4 and 10.9 minutes more MVPA per day at 3 and 6 weeks respectively (P < .001). Participation significantly increased the proportion of children who met the Australian 24-Hour Movement Guidelines (P < .001). At pre, middle and end of intervention, 44.4%, 60.8% and 55.1% of intervention children and 46.5%, 45.9% and 45.8% of controls met the guidelines. Significantly fewer students engaged in off-task behaviour in the intervention classes at mid and final weeks of intervention (-1.4 students, P = .003). No significant intervention effects were found for wellbeing, cognitive and maths performance.

CONCLUSIONS

Active classroom breaks are an effective way to increase physical activity among primary school children while reducing off-task classroom behaviour. SO WHAT?: Primary school students' health would benefit from active breaks with no detrimental effects on wellbeing, maths and cognitive performance.

Effects of Cognitively Engaging Physical Activity on Preschool Children's Cognitive Outcomes

Research combining physical activity with the training of cognitive skills such as executive functions is emerging as a novel and fruitful intervention approach for children. Purpose: This study aimed to examine the impact of an intervention program including cognitively engaging physical activity on preschool children's cognitive outcomes and physical activity. Methods: Children (N = 144, 65 female; Mage = 4.41 years, SD = 0.61), randomly assigned to one of three groups: cognitively engaging physical activity (CPA; i.e., storytelling, cognitive activities, and motor tasks, n = 55), cognition (i.e., storytelling and cognitive activities without motor tasks, n = 48), or control (i.e., traditional storytelling, n = 41). Sessions lasted approximately 17 minutes, conducted twice a week, for 6 weeks. Children's executive function, self-regulation, and related outcomes (i.e., numeracy) were assessed at baseline and again-along with perceived enjoyment-at the end of the program. Accelerometers measured children's physical activity during each session. Teachers completed a logbook for each session, and two fidelity checks per preschool took place by the researcher. Main analyses used linear mixed models adjusted for covariates (age, sex) and clustering at the preschool level. Results: Results showed no significant group by time interaction for executive function, self-regulation, numeracy, enjoyment. During the sessions, children in the CPA group were more physically active than children in the cognition and control groups. Conclusion: While we did not find the expected amplified cognitive benefits, making storytelling more active has the potential to meet two needs (increase cognitive stimulation and physical activity levels) in one deed.

Protocol Study: Resistance Training Program, Nutritional, Sleep, and Screen Use Recommendations in Schoolchildren from Educational Centers in the Extreme South of Chile

BACKGROUND

Childhood obesity has tripled, reaching critical levels of malnutrition. This factor is directly associated with a poorer health-related quality of life of the child and adolescent population. This article presents the study protocol of the project "Strong schoolchildren with a healthy lifestyle" (EF-Salud), which seeks to analyze the effects of a multicomponent program based on muscle strength exercises, sleep nutritional recommendations, and the use of screens in Chilean educational centers with extremely cold weather.

METHODS

The study protocol of a randomized controlled trial with a pre- and post-test conducted according to the CONSORT statement is reported. The total sample (n = 144) will be schoolchildren from six different school years, four of which will perform an intervention and two control. Intervention group 1 (from two different school years) will receive a muscular strength exercise program in the classroom once a day from Monday to Friday for six months and nutritional, sleep, and use of screens recommendations once a week. Intervention group 2 (from two different school years) will receive a program of nutritional, sleep, and use of screens recommendations once per week for six months. The control group (from two different school years) will carry out their usual school day in relation to physical education classes. Before and after the intervention, the investigators will evaluate the cardiovascular risk, physical condition, and lifestyle related to sleep and use of screens.

EXPECTED RESULTS

The schoolchildren in intervention group 1 will obtain significant results in increased strength, decreased cardiovascular risk, improved sleep habits, and fewer hours of screen use compared to the other two groups.

Use of a toolbox of tailored evidence-based interventions to improve children's physical activity and cardiorespiratory fitness in primary schools: results of the ACTIPROS cluster-randomized feasibility trial

BACKGROUND

School-based physical activity (PA) promotion is usually conducted by providing one specific intervention. In contrast, the ACTIvity PROmotion via Schools (ACTIPROS) toolbox provides a set of twelve evidence-based PA interventions serving different domains of the Health Promoting Schools framework that primary schools can select according to their requirements. In this study, we tested the feasibility of the toolbox approach in primary schools.

METHODS

A two-arm cluster-randomized feasibility trial at primary schools (n = 5 intervention schools [IS], n = 5 control schools) located in the Federal State of Bremen, Germany, was conducted. Children's habitual PA (GENEActiv, Activinsights Ltd.) and motor skills (Deutscher Motorik Test; DMT) were measured at the beginning (t0: Sept and Oct 2021) and at the end of the school year (t1: June and July 2022). Between Oct 2021 and July 2022, the ACTIPROS toolbox was implemented at IS. Teachers documented intervention choices and implementation within a short questionnaire (SIQ) at t1.

RESULTS

IS successfully implemented at least one intervention of the toolbox. In total, seven out of twelve possible interventions were selected. Two schools decided to replace an intervention with another during the trial. Results of the SIQ indicated that IS tended to choose similar interventions while implementation frequency was highly different. N = 429 students from two classes per school were recruited. The mean consent rate was 75.1% (n = 322). At t0 and t1, n = 304 (94.4%) and n = 256 (79.3%) of consented children took part in the DMT, respectively. The accelerometry sample included one class per participating school. At t0 and t1, n = 166 and n = 151 devices were handed out to students and n = 133 (80.1%) and n = 106 (70.2%) valid records could be retrieved, respectively. Linear mixed models showed an intervention effect of 15.5 min (95% CI: 4.5; 26.6) in children's daily MVPA at IS between t0 and t1 compared to controls.

CONCLUSIONS

All IS were able to implement at least one intervention from the toolbox, and unsuitable interventions were successfully replaced in a timely manner, highlighting the feasibility of implementing the ACTIPROS toolbox. Good consent rates for accelerometer and motor skills data were achieved. Results indicate a substantial increase in MVPA associated with the ACTIPROS toolbox and need to be tested in a larger sample.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00025840.

Effect of physical activity interventions on children's academic performance: a systematic review and meta-analysis

The physical and psychological benefits of physical activity are well established. However, there is no consensus regarding the effects of physical activity on children's academic performance in general and in specific subjects. We conducted this systematic review and meta-analysis to identify forms of physical activity that are suitable for improving the physical activity levels and academic performance of children aged 12 years and under. The PubMed, Web of Science, Embase, and Cochrane Library databases were searched. Included studies had to meet the following criteria: randomized controlled trials examining the effect of physical activity interventions on children's academic performance. Stata 15.1 software was used to conduct the meta-analysis. A total of 16 studies were included, and the results showed that the "physical activity + academic curriculum" format had a positive effect on children's academic performance. Physical activity had a stronger effect on math performance than on reading and spelling performance (SMD = 0.75, 95% CI: 0.30,1.19, P < 0.001).   Conclusion: The impact of physical activity on children's academic performance varies based on the type of physical activity intervention, with "physical activity + academic curriculum" format having a better effect on academic performance. The effect of physical activity interventions on children's academic performance also varies by subject; the effect is strongest for math.    Trial registration: Registration and protocol CRD42022363255. What is Known: • The physical and psychological benefits of physical activity are well established. • Previous meta-analyses have failed to demonstrate the impact of physical activity on the general and subject-specific academic performance of children aged 12 and under. What is New: • The PAAL form of physical activity has a better effect on the academic performance of children aged 12 and under. • The benefit of physical activity also varies by subject, with the greatest effect being observed for math.

Cross-Lagged Associations between Physical Activity, Motor Performance, and Academic Skills in Primary School Children

PURPOSE

Few longitudinal studies have investigated the interwoven longitudinal dynamics between physical activity (PA), motor performance, and academic skills in middle childhood. Therefore, we investigated the cross-lagged associations between PA, motor performance, and academic skills from grade 1 to grade 3 in Finnish primary school children.

METHODS

A total of 189 children 6-9 yr old at baseline comprised the study sample. Total PA was assessed using a questionnaire filled out by parents, moderate-to-vigorous PA by combined heart rate and body movement monitor, motor performance by 10 × 5-m shuttle run test, and academic skills by arithmetic fluency and reading comprehension tests in grade 1 and grade 3. Data were analyzed using structural equation modeling adjusted for gender, parental education, and household income.

RESULTS

The final model fitted the data very well ( χ237 = 68.516, P = 0.0012, root-mean-square error of approximation = 0.067, comparative fit index = 0.95, Tucker-Lewis Index = 0.89) and explained 91% of variance in the latent academic skills variable, 41% of the variance in the latent PA variable, and 32% of variance in motor performance in grade 3. Better motor performance in grade 1 was associated with higher academic skills in grade 3, but it did not predict PA. PA was not directly or indirectly associated with academic skills. However, higher levels of PA in grade 1 predicted better motor performance in grade 3. Academic skills did not predict PA or motor performance.

CONCLUSIONS

These results suggest that better motor performance, but not PA, predicts later academic skills. Academic skills in grade 1 do not contribute to PA or motor performance in the early school years.

Approaching physically active learning as a multi, inter, and transdisciplinary research field

In broad terms, physically active learning is a phenomenon that combines health and educational disciplines to integrate physical activity and core educational goals. Despite a growing research interest within the physically active learning field, conceptual clarity on combining and synthesising research disciplines appears to be needed. This article thus explores knowledge production within the physically active learning research field. First, it outlines the origin of the research field. Secondly, the terms multi-, inter-, and transdisciplinary are applied to confront how knowledge is produced. Finally, the three approaches' theoretical and ethical implications are discussed. The article contributes to conceptual clarity within the field by proposing that physically active learning is inherently inter- and transdisciplinary because it embraces the complexity of integrating and synthesising knowledge from health and educational disciplines to address real-world problems. To conclude, awareness of physically active learning's practical and theoretical dimensions through the three approaches is central to evolving the field.

Association of Socioeconomic Factors and Physical Activity with Health-Related Quality of Life in Italian Middle School Children: An Exploratory Cross-Sectional Study

Health-related quality of life (HRQoL) provides a broad assessment of an individual's well-being and can serve as a good prognosticator of life's outcomes later for children and adolescents. Understanding the factors associated with HRQoL is crucial for promoting better health and life satisfaction. This study investigated the cross-sectional association of socioeconomic status, cardio fitness, and physical activity levels with HRQoL in 224 Italian early adolescents attending secondary school in the Emilia-Romagna region located in Northern Italy. In a multivariate path regression model, younger students and females reported a higher quality of life (β = -0.139, p = 0.015, 95% CI: -0.254--0.023 and β = 0.142, p = 0.019, 95% CI: 0.011-0.273, respectively). Having both parents employed and having a higher familiar educational status were also associated with a higher quality of life (β = 0.142, p = 0.013, 95% CI 0.027-0.257 and β = 0.133, p = 0.017, 95% CI 0.022-0.244, respectively). Greater engagement in routine physical activity levels from moderate to vigorous intensity was positively associated with quality of life (β = 0.429, p < 0.001, 95% CI: 0.304-0.554). Endurance (speed) was positively associated with quality of life (β = 0.221, p = 0.001, 95% CI: 0.087-0.355), and students with longer times on the shuttle run reported less quality of life (β = -0.207, p = 0.002, 95% CI: -0.337--0.077). These relations remained intact even when controlling for socioeconomic factors. The current findings reinforce the importance of promoting regular physical activity among younger children and also addressing socioeconomic status disparities to improve children's well-being. Future studies may want to consider expanding the array of measures used to assess physical activity and include additional measures assessing nutrition, cultural factors, and family functioning, all of which can influence a child's willingness to engage in physical activity and their well-being. The emphasis on fitness and physical activity and their contribution to a child's well-being should be the prime focus for stakeholders who work in the education, public health, and health policy sectors.

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.

Identifying opportunity, capability and motivation of Sri Lankan 5th grade schoolteachers to implement in-classroom physical activity breaks: A qualitative study

BACKGROUND

Classroom-based physical activity interventions have demonstrated positive effects in reducing sedentary behaviour among school children. However, this is an understudied area, especially in low- and middle-income countries such as Sri Lanka. This study aims to explore teachers' opportunity, capability and motivation relating to the implementation of an in-classroom physical activity breaks programme.

METHODS

Twenty-seven teachers were recruited through snowball sampling and participated in semi-structured telephone interviews from early-January to the mid-June 2022. The Capability, Opportunity, and Motivation Behaviour (COM-B) model was used to guide and deductively thematic analyse the interviews.

RESULTS

21 out of the recruited teachers responded to the full study. The mean age of respondents was 39.24 years old ranging from 27 years to 53 years. Teaching experience of the respondents ranged from three to 37 years, and 57% were female. Three teachers had a degree with a teacher training diploma, while others were having General Certificate of Education in Advanced Level with a teacher training diploma as the highest education qualification. Capability factors such as age, dress code, mask wearing, knowledge, skills and workload of the teachers were identified as important factors in implementing a physical activity breaks intervention in a Sri Lankan classroom setting. Classroom space, facilities, student backgrounds and safety were identified as opportunity factors. Obtaining policy level decisions to implement the activity breaks and managing the time of the activities to reduce time lost in education time were identified as motivational factors.

CONCLUSION

During the intervention development phase, implementation facilitators and barriers must be considered carefully. Behaviour change techniques can be utilised to address the identified COM-B factors to ensure a good implementation of the intervention.

Physical Education: At the Centre of Physical Activity Promotion in Schools

Whilst recognising and advocating for the role and importance of schools and whole school approaches to the promotion of physical activity in schools, this paper argues that physical education (PE) should be at the centre of and driving schools' efforts to promote physical activity. Various reasons are given for this, with these broadly centring on the unique goal, nature, and responsibilities of the subject with respect to promoting physically active lifestyles and health-related learning. Furthermore, there have been positive strides in recent years to support this endeavour and that serve to highlight, strengthen, and reinforce the focus and responsibility of PE in the promotion of physical activity. In light of these, it is suggested that it is a pivotal time for PE. Equally, it is accepted that PE faces some longstanding challenges that are hindering and raise questions concerning the subject's physical activity promotion efforts. Despite this, it is contended that these should not be unsurmountable, and more recent developments should also help the subject to realise its physical activity promoting potential moving forwards. In particular, the critical importance of high-quality PE that has young people at the core is highlighted. It is concluded that it is both time and timely for the PE profession to be bold, have confidence, and grasp these opportunities and ensure that high-quality PE is central to the explicit planning and co-ordination of meaningful, coherent, relevant, and sustainable physical activity opportunities for young people in schools.

Current and preservice teachers' views and beliefs regarding martial arts and the inclusion of martial arts in Australian school settings: A cross-sectional study

Purpose

This study investigates views and beliefs of current and preservice teachers regarding martial arts (MA) and the inclusion of martial arts in schools.

Methods

Participants completed an anonymous, 28-item questionnaire made available online via Qualtrics (August-November 2020). Data was analysed using SPSS software to compare mean scores by sex, and between qualified teachers and preservice teachers. Qualitative data in the form of quotes was drawn upon and used to complement the quantitative results.

Results

Results indicate teachers and preservice teachers view MA as a worthwhile and beneficial activity for school-aged students, and support the inclusion of MA into school settings.

Conclusion

These findings may be useful to inform policy and practice in schools, and the development of teacher education programs, professional development courses, and school-based education programs utilizing MA to meet physical education learning outcomes.

Effects of a daily physical activity intervention on the health-related fitness status of primary school children: A cluster randomized controlled trial

An important barrier for a nationwide implementation of a daily physical activity (PA) at primary schools is the lack of spatial and human resources. Therefore, we developed a PA intervention that can be implemented without additional spatial resources or changes in school curricula. In the intervention group, children received a daily PA unit consisting of physical education lessons and simultaneous academic content over a 9-month period. The control group received conventional (physical education) classes. Body weight, height, waist circumference and health-related fitness parameters were measured. Of 412 children (9.7 ± 0.5 years) included, 228 participated in the intervention group. In regression analysis adjusted for baseline, gender, school location, sports club membership (total only) with standardized outcome variables, the intervention group showed a reduction in waist-to-height ratio (B = 0.30, p < 0.001) and an increase in several fitness parameters (cardiorespiratory endurance: B = 0.20, p = 0.037; lower body muscle strength: B = 0.11, p = 0.041; lower body muscle endurance: B = 0.12, p = 0.027; flexibility: B = 0.19, p = 0.019) compared to the control group. Intervention effects for cardiorespiratory endurance and flexibility were more pronounced in the group of children without sports club membership. Thus, especially children with no sport club membership seem to benefit from daily PA in school (Trial registration: DRKS00025515).

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.

A Three-Fold Integrated Perspective on Healthy Development: An Opinion Paper

Mental health and wellbeing are increasingly threatened in the current post-pandemic times, with stress, especially in students, reaching preoccupying levels. In addition, while many educational programs are unidimensional (i.e., lacking integration between physical, emotional and cognitive elements), there are ways to promote physical, social and mental health in children and adolescents. In this opinion paper, we will discuss the importance of an integrative approach for health development and examine relevant factors, such as awareness and emotional intelligence. We will highlight evidence ranging from behavioral to electrophysiological, structural and molecular, and report several recent studies supporting the effectiveness of a holistic approach in supporting wellbeing and creativity in children and adults, and detailing a specific paradigm named the Quadrato Motor Training (QMT). QMT is a specifically structured movement meditation, involving cognitive, motor and affective components. Finally, we will support a holistic view on education, integrating motion, emotion and cognition to develop a person-centered, or in this case student-centered, approach to wellbeing and health.

Impact of an Interdisciplinary Educational Programme on Students' Physical Activity and Fitness

Educational initiatives and actions are needed to provide students with skills to create active habits and lifestyles in order to increase the physical activity and fitness levels of young people. The main objective of this study was to analyse the effects of a classroom-based physical activity and life skills programme on students' physical activity and fitness levels. The sample consisted of 65 students in the 6th grade of Primary Education, aged between 11 and 13 years (11.86 ± 0.53), divided into a control group (CG) and an experimental group (EG) for convenience and accessibility. This was a quasi-experimental, repeated measures, longitudinal cut-off research design. For 16 weeks, an interdisciplinary educational programme based on a combination of classroom-based physical activity and life skills was implemented. The results showed that the educational programme had a positive effect on students' physical activity levels during school hours, specifically on reducing sedentary time (p < 0.001) and increasing light (p < 0.001) and moderate-to-vigorous (p < 0.001) physical activity. Positive effects were also found on the variables of explosive strength (p < 0.05) and aerobic capacity (p < 0.05) related to physical fitness. In conclusion, interdisciplinary educational programmes based on the promotion of physical activity and life skills could contribute to the development of responsible daily physical activity habits in students to facilitate their transfer to other environments (social and family) outside school.

Classroom-Based Physical Activity as a Means to Improve Self-Efficacy and Academic Achievement among Normal-Weight and Overweight Youth

Although physical activity has positive physical and mental health outcomes, particularly among adolescents, a significant percentage of young people maintain a largely sedentary lifestyle. Considering that the youths spend the greater part of the day at school, this is considered an ideal setting to foster active and healthy living. Consequently, this study is intended to investigate the connection between physical activity, self-efficacy and academic achievement in normal-weight and overweight adolescents. In total, 100 students (aged 14-15) from a public high school placed in the south of Italy were enrolled. They participated either in a 12-week classroom-based physical activity break program performed during science classes (60'/2 days per week) in which a nutritional educational program was carried out or in regular science lessons (60'/2 days per week). At the beginning and end of the intervention programs, a set of standardized motor evaluation tests (standing long jump test, Harvard step test, push up, sit and reach test), the scholastic self-efficacy test and the Amos 8-15 were administered. As a result, a meaningful Time × Group interaction for the self-efficacy variable and Amos 8-15 was observed in the intervention group. Specifically, they reported significant improvement in study skills, motivational factors, concentration and self-efficacy, as well as a decrease in anxiety and BMI (p < 0.001). No significant change was observed in the control group. The conclusions of this research underpin the notion that classroom-based physical activity break is a successful approach for enhancing students' psycho-physical well-being, as well as academic achievement.

Physical activity predicts task-related behaviour, affect and tiredness in the primary school classroom: A within-person experiment

AIM

We investigated the dose-response relationship between acute physical activity (PA) intensity during physical education (PE) lessons (dose), and task behaviour and learning experiences in the classroom after PE (response), and mediation effects of acute PA on-task behaviour via learning experiences.

METHOD

A total of 78 children (Mage  = 9.30 years; 43 females) took part. Participants reported learning experiences (tiredness, positive and negative affect) during one afternoon per week for 6 weeks. Their task behaviour was observed (on-task, active off-task and passive off-task) during two classroom lessons. Between the classroom lessons, they took part in a PE lesson, with experimentally induced PA intensity (low, medium and high). Accelerometers were worn for 24 h leading up to and during every intervention afternoon. Participants completed self-reports three times per classroom lesson, both before and after PE. Intra- and interindividual differences in PA, task behaviour and learning experiences were analysed with multilevel structural equation models.

RESULTS

Moderate PA directly increased on-task behaviour and reduced passive off-task behaviour, whereas light PA increased active off-task behaviour and reduced on-task behaviour. We found no direct effects of vigorous PA or mediated effects of any PA intensity on-task-related behaviour. However, a greater positive affect during PE indirectly led to more on-task and less passive off-task behaviour. Regularly active children reported less tiredness in the classroom.

CONCLUSION

PE lessons can increase on-task behaviour and reduce both passive and active off-task behaviours. Positive affect and tiredness are indirectly involved in the impact of PA on task-related behaviour. The greatest benefits were found for moderate PA and for PE lessons, which left children feeling positive. Moreover, regular participation in moderate-to-vigorous PA leads children to feel less tired during school lessons.

Complementary and Integrative Treatments for Attention-Deficit/Hyperactivity Disorder in Youth

First-line psychopharmacologic and psychosocial treatments for attention-deficit/hyperactivity disorder in children are effective but limited by tolerability and accessibility problems. Many complementary and integrative strategies have been investigated as alternative or adjunctive treatments for the disorder, and the literature has progressed to meta-analyses for several. Although heterogeneity of study methods and risk of bias pervades the literature, we conclude that Omega-3 supplementation, dietary restriction of artificial food colorings, and physical activity can be considered evidence-based. Additionally, meditation, yoga, and sleep hygiene are safe, partially effective, cost effective and sensible adjunctive treatment strategies.