The Effect of a School-Based Intervention on Physical Activity and Well-Being: a Non-Randomised Controlled Trial with Children of Low Socio-Economic Status

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.

Autonomous motivation, social support, and physical activity in school children: moderating effects of school-based rope skipping sports participation

Purpose

Recent studies have shown that physical activity (PA) levels are low among children and adolescents globally. In order to reverse this trend, PA interventions are increasingly favoured. The school setting is the ideal place to address the issues that many children face. The purpose of this study was to (a) The primary focus of this study is to delve into the mediating role played by school-based rope skipping sports participation (SRSP) in the connection between social support and moderate to high-intensity physical activity (MVPA) among school children. (b) Additionally, this research aims to examine the moderating effect of within this pathway.

Methods

We conducted a survey involving 721 adolescents residing in Changsha City. The participants' ages ranged from 8 to 12 years, with an average age of 9.84 ± 1.535 years. Out of these participants, 406 were boys, and 315 were girls. To assess variables such as social support and autonomous motivation, we employed standardized measurement scales. Subsequently, we analyzed the collected data using various statistical methods, including independent s-amples t-tests, bivariate correlation analysis, descriptive statistical analysis, structural equation modeling (SEM), and the Johnson-Neyman method.

Results

An independent samples t-test revealed a statistically significant difference in MVPA between genders (p = 0.003 < 0.05), with boys exhibiting a higher level of engagement in MVPA compared to girls, Correlation analysis revealed significant positive associations among several key variables. Specifically, social support demonstrated a noteworthy positive correlation with autonomous motivation (r = 0.331, p < 0.01) as well as school children's engagement in MVPA (r = 0.308, p < 0.01). Moreover, autonomous motivation displayed a significant positive correlation with school children's involvement in MVPA (r = 0.459, p < 0.01). The moderating analysis revealed a significant influence of the interaction between increased participation in and social support on school children's engagement in MVPA.

Conclusion

Social support and autonomy support have been proven effective in enhancing school children's engagement in MVPA. They exert their influence indirectly by fostering autonomous motivation. Notably, robust social support can significantly benefit MVPA school children with high activity requirements, particularly those regularly engaged in MVPA during the school day.

A systematic review of the effect of The Daily Mile™ on children's physical activity, physical health, mental health, wellbeing, academic performance and cognitive function

BACKGROUND

A minority of children in the United Kingdom meet the recommended physical activity guidelines. One initiative which has been introduced to try and increase the physical activity levels of school children is The Daily Mile™ (TDM). The aim of this review was to determine the effect of TDM on children's physical activity levels, physical health, mental health, wellbeing, academic performance and cognitive function.

METHODS

Six databases were systematically searched from TDM's inception (2012) to 30th June 2022. Studies were included if they involved school-aged children (aged 4-12 years), taking part in TDM and measured at least one pre-defined outcome.

RESULTS

Thirteen studies were included from the 123 studies retrieved. Longer-term participation in TDM was found to increase moderate-to-vigorous physical activity and physical fitness. None of the studies reported a significant change in Body Mass Index or academic performance. An acute bout of TDM was not found to improve cognitive function, however one good-quality study reported that longer-term participation in TDM increased visual spatial working memory. There was evidence from one fair-quality design study that TDM can improve mental health in the short term. There were no significant effects on wellbeing, however scores on self-perceptions improved mainly for children with low baseline self-perceptions.

CONCLUSION

There is evidence to show that TDM can increase physical activity and physical fitness. However, higher-quality research, with adequate participant randomisation and longer-term, post-intervention follow-up is needed to ensure that any changes accurately reflect the components of TDM and are sustained beyond an intervention time frame. Policy recommendations of TDM increasing PA levels in the short term are supported by the evidence in this review. However, long-term improvement on mental health, wellbeing, academic performance and cognitive function requires further good-to excellent quality research. Promisingly, several protocol articles that include randomised controlled trials with long term follow-up have been published. These higher-quality design studies may provide a stronger evidence-base on the effects of TDM on children's health and should underpin future recommendations in public health policy.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022340303.

Differences and Associations between Physical Activity Motives and Types of Physical Activity among Adolescent Boys and Girls

Interventions aimed at motivation for physical activity (PA) are mostly beneficial, but the effects on preventing the decrease in PA are not entirely clear, especially in girls. The main aim of this study was to identify the differences and associations between PA motives and types of PA in boys and girls and between low and high motivated boys and girls. Another aim is to identify the types of motivation and PA that increase the likelihood of achieving PA recommendations and to propose ways of increasing PA among low motivated adolescents. The research carried out before the COVID-19 pandemic (2010–2019) and involved 2,149 Czech and 1,927 Polish adolescents aged 15–19 years. The International Physical Activity Questionnaire-Long Form was used to identify the level of PA types, while PA motivation was examined through the Motives for Physical Activities Measure-Revised. During the ten years, a decline was observed in enjoyment, fitness, and social motives. An increase in appearance motives was observed in girls, while no significant changes were seen in boys. Boys showed a higher motivation for PA than girls in enjoyment, competence, fitness, and social motives, while girls were high motivated in appearance motives. The greatest statistically significant differences between low and high motivated individuals were found in the associations between recreation/vigorous PA and between all types of motivation in boys and girls in both countries. The strongest associations in both genders were observed between enjoyment/competence motives and recreation/vigorous PA. Respecting and using the associations between the types of PA motives and types of PA in low and high motivated boys and girls can support feelings of PA enjoyment, increase PA, support the achievement of PA recommendations, and positively affect adolescents' healthy lifestyles.

Characterizing Middle School Students' Physical Literacy Development: A Self-Determination Theory-Based Pilot Intervention in Physical Education

Purpose: Positive youth development (PYD) can be achieved through effective and purposeful instructions in physical education (PE) and other relevant experiences both in and beyond schools. Students' PYD is associated with their physical literacy (PL) development, which has become a primary emphasis of PE, especially in the United States, in recent years. This study aimed to (a) characterize middle school students' physical literacy (PL) and (b) capture their PL developing trajectories in light of receiving a self-determination theory (SDT)-based pedagogical workshop, with the long-term vision on PYD.

Methods: Participants (N = 226) completed the Canadian Assessment of Physical Literacy (CAPL-2) in physical education (PE). A subsample (n = 49) received four workshop sessions over 8 weeks; and completed the CAPL-2 and participated in focus group interviews before and after the workshop.

Results: Both boys and girls' CAPL-2 scores were in the “progressing” stage. Significant differences in PL and PL domains were observed by gender, grade, socioeconomic status (SES), body mass index (BMI), and race/ethnicity. The low PL group showed improvements in PL and PL domains. Interview data delineated positive PL developing trajectories for physical activity (PA) type, frequency, and intensity; perceived motives; and participation barriers.

Conclusion: PL is a dynamic state that can be improved through purposeful PE. Future work should examine the effect (and implementation) of opportunities in (e.g., PE) and beyond schools (e.g., youth sports programs) to ultimately advance PYD.

Effectiveness and cost-effectiveness of the PLAN-A intervention, a peer led physical activity program for adolescent girls: results of a cluster randomised controlled trial

BACKGROUND

Physical activity is associated with improved health. Girls are less active than boys. Pilot work showed that a peer-led physical activity intervention called PLAN-A was a promising method of increasing physical activity in secondary school age girls. This study examined the effectiveness and cost-effectiveness of the PLAN-A intervention.

METHODS

We conducted a cluster randomised controlled trial with Year 9 (13-14 year old) girls recruited from 20 secondary schools. Schools were randomly assigned to the PLAN-A intervention or a non-intervention control group after baseline data collection. Girls nominated students to be peer leaders. The top 18 % of girls nominated by their peers in intervention schools received three days of training designed to prepare them to support physical activity. Data were collected at two time points, baseline (T0) and 5-6 months post-intervention (T1). Participants wore an accelerometer for seven days to assess the primary outcome of mean weekday minutes of moderate-to-vigorous physical activity (MVPA). Multivariable mixed effects linear regression was used to estimate differences in the primary outcome between the two arms on an Intention-to-Treat (ITT) basis. Resource use and quality of life were measured and a within trial economic evaluation from a public sector perspective was conducted.

RESULTS

A total of 1558 girls were recruited to the study. At T0, girls in both arms engaged in an average of 51 min of MVPA per weekday. The adjusted mean difference in weekday MVPA at T1 was - 2.84 min per day (95 % CI = -5.94 to 0.25) indicating a slightly larger decline in weekday MVPA in the intervention group. Results were broadly consistent when repeated using a multiple imputation approach and for pre-specified secondary outcomes and sub-groups. The mean cost of the PLAN-A intervention was £2817 per school, equivalent to £31 per girl. Economic analyses indicated that PLAN-A did not lead to demonstrable cost-effectiveness in terms of cost per unit change in QALY.

CONCLUSIONS

This study has shown that the PLAN-A intervention did not result in higher levels of weekday MVPA or associated secondary outcomes among Year 9 girls. The PLAN-A intervention should not be disseminated as a public health strategy.

TRIAL REGISTRATION

ISRCTN14539759 -31 May, 2018.

The Seneb's Enigma: Impact of a Hybrid Personal and Social Responsibility and Gamification Model-Based Practice on Motivation and Healthy Habits in Physical Education

Increasing physical activity (PA) and personal and social values are two of the greatest demands in the current educational system. This study examined the effects of a program based on the hybridization of the Personal and Social Responsibility Model and gamification. A total of 58 students (13.89 years old, SD = 1.14) in two groups (experimental and control) participated during a complete academic year. Motivation, physical activity and sedentary behavior were assessed through questionnaires. Physical fitness was evaluated using previously validated field tests. The results showed significant differences over time between the experimental group (EG) and control group (CG) in afterschool physical activity (APA) during the weekend (p = 0.003), sedentary time (p = 0.04) and speed–agility (p = 0.04). There were no significant differences in motivation. In reference to the intervention, the speed–agility (p = 0.000), strength (p = 0.000), agility (p = 0.000), cardiorespiratory fitness (p = 0.001), APA–weekend (p = 0.000), APA–week (p = 0.000) and sedentary time (p = 0.000) increased significantly in the EG. The speed–agility (p = 0.000), APA–weekend (p = 0.03) and sedentary time (p = 0.008) increased in the CG. The implementation of a program based on the hybridization of pedagogical models can be useful in producing improvements in physical fitness, physical activity and sedentary behaviors.

Athletes' Psychological Needs and Coaches' Interpersonal Behaviors: A Within-Person Latent Profile Analysis

Basic psychological needs theory is limited by variable-centered studies focused on linear relationships between perceived needs-supportive/controlling coach behaviors. Therefore, latent profile analysis was used to determine if heterogenous profiles emerged from the interactive effects of needs-supportive and -controlling coach behaviors and the subsequent association with sport-specific mental health outcomes (i.e., burnout and subjective vitality). A total of 685 athletes took part (age = 23.39 years, male = 71%), and the latent profile analysis revealed five novel, diverse profiles, labeled as "supportive-developmental," "needs-indifferent," "overly critical," "harsh-controlling," and "distant-controlling" coaches. The profiles predicted significant mental health variance (adjusted R2 = .15-.24), wherein the "supportive-developmental" profile scored most favorably on 90% of the outcomes. The largest mean differences were observed against the "harsh-controlling" (n = 5), "overly critical" (n = 3), and "distant controlling" (n = 2) profiles. Overall, latent profile analysis revealed substantial nuance in athletes' social contexts, predicting variance in mental health. Needs-supportive interventions are needed for "overly critical," "harsh controlling," and "distant controlling" athlete profiles.

The Impact of English Learning Motivation and Attitude on Well-Being: Cram School Students in Taiwan

As English is a global language, it is important for students to learn it effectively and efficiently. Learning English from English cram schools is very popular in Taiwan. Most students have studied in English cram schools for some period of time of their English learning experience. The present study concerns about how English cram school learners’ English learning attitudes related to their learning motivation and learning well-being in Taiwan. By using the quantitative research methodology, an empirical research model has been proposed and 277 valid questionnaires were collected. The research results show that learning motivation has a significant impact on learning attitude and learning well-being. Then, the English learning attitude provides mediated effects between learning motivation and well-being. Learning attitude is the key to English learning well-being. Furthermore, a participant’s gender has a significant moderating effect between learning intrinsic motivation and attitude. According to research findings, some suggestions such as using e-learning tools were provided for teachers and educators of the cram schools in Taiwan.

A Preliminary Investigation of the Relationship between Motivation for Physical Activity and Emotional and Behavioural Difficulties in Children Aged 8-12 Years: The Role of Autonomous Motivation

While motivation for physical activity (PA) and PA participation have been linked, research on the relationship between motivation for PA and mental health outcomes is scant, with studies involving children largely underrepresented. Grounded in self-determination theory, this cross-sectional study aimed to determine whether autonomous motivation versus external motivation (a form of controlled motivation) for PA is associated with fewer emotional and behavioural difficulties and higher levels of PA in children. A sample of 87 children (aged 8–12 years) were recruited from five primary schools in Victoria, Australia. An adapted version of the Behavioural Regulation in Exercise Questionnaire (BREQ) was used to measure motivation for PA and structured parent-report questions were used to assess moderate-to-vigorous PA (MVPA) levels. Parents also completed the Strengths and Difficulties Questionnaire (SDQ) to measure children’s emotional and behavioural difficulties. Children’s autonomous motivation was associated with fewer emotional and behavioural difficulties (β = −0.25, p = 0.038) and higher levels of MVPA (β = 0.24, p = 0.014). These results indicate autonomous motivation is associated with improved mental health outcomes and higher levels of PA in children. Thus, PA interventions that promote autonomous motivation may enhance children’s mental health compared to interventions that promote mainly controlled forms of motivation.

School-related physical activity interventions and mental health among children: a systematic review and meta-analysis

BACKGROUND

Low levels of physical activity, sedentary behaviour and mental health problems are issues that have received considerable attention in the last decade. The aim of this systematic review and meta-analysis was to investigate effects of interventions targeting school-related physical activity or sedentary behaviour on mental health in children and adolescents and to identify the features of effective interventions.

METHODS

Scientific articles published between January 2009 and October 2019 fulfilling the following criteria were included: general populations of children and adolescents between age 4 and 19, all types of school-related efforts to promote physical activity or reduce sedentary behaviour. Study selection, data extraction and quality assessment were done by at least two authors independently of each other. Data were analysed with a random effects meta-analysis and by narrative moderator analyses.

RESULTS

The literature search resulted in 10265 unique articles. Thirty-one articles, describing 30 interventions, were finally included. Eleven relevant outcomes were identified: health-related quality of life, well-being, self-esteem and self-worth, resilience, positive effect, positive mental health, anxiety, depression, emotional problems, negative effect and internalising mental health problems. There was a significant beneficial effect of school-related physical activity interventions on resilience (Hedges' g = 0.748, 95% CI = 0.326; 1.170, p = 0.001), positive mental health (Hedges' g = 0.405, 95% CI = 0.208; 0.603, p = < 0.001), well-being (Hedges' g = 0.877, 95% CI = 0.356; 1.398, p = < 0.001) and anxiety (Hedges' g = 0.347, 95% CI = 0.072; 0.623, p = 0.013). Heterogeneity was moderate to high (I² = 59-98%) between studies for all outcomes except positive effect, where heterogeneity was low (I² = 2%). The narrative moderator analyses of outcomes based on 10 or more studies showed that age of the children moderated the effect of the intervention on internalising mental health problems. Interventions in younger children showed a significantly negative or no effect on internalising mental health problems while those in older children showed a significant positive or no effect. Moreover, studies with a high implementation reach showed a significant negative or no effect while those with a low level of implementation showed no or a positive effect. No signs of effect moderation were found for self-esteem, well-being or positive mental health. Risk of publication bias was evident for several outcomes, but adjustment did not change the results.

CONCLUSIONS

School-related physical activity interventions may reduce anxiety, increase resilience, improve well-being and increase positive mental health in children and adolescents. Considering the positive effects of physical activity on health in general, these findings may reinforce school-based initiatives to increase physical activity. However, the studies show considerable heterogeneity. The results should therefore be interpreted with caution. Future studies should report on implementation factors and more clearly describe the activities of the control group and whether the activity is added to or replacing ordinary physical education lessons in order to aid interpretation of results.

TRIAL REGISTRATION

PROSPERO, CRD42018086757.

School-based Physical Activity Interventions in Children and Adolescents: A Systematic Review

Background: The aim of this systematic review was to examinemotivational interventions based on physical activity as precursor of psychosocial benefits inside of the scholar context. Method: studies were identified in seven databases (Web of Science, Sport Discuss, Scopus, Eric, Pubmed, Psycinfo and Google Scholar). The search process was from June 2011 to September 2019. A total of 41 articles met the inclusion criteria. Results: 23 studies showed psychological effects after intervention and also 10 studies showed psychosocial effect after the intervention. The rest of the studies, although they presented changes, did not become significant. Conclusions: this systematic review showed the importance of motivational processes for the performance of physical activity and sport as a precursor of psychosocial changesand highlights the importance of strategies and the temporal nature of studies to maintain significant changes over time.Likewise, the study shows the future trend of motivational interventions, highlighting the female gender as participants of special interest, and changing the methodology through web-based interventions and active breaks or mental breaks during traditional subject classes.

Effects of a Mental Health Intervention in Athletes: Applying Self-Determination Theory

Introduction: Many sport associations have responded to mental health issues in sport through the inclusion of self-management programs, such as mindfulness training, which may improve well-being through increasing one's competence in self-regulating stressors. Yet, the mechanisms accounting such changes lack a theoretical basis, particularly in athletes. Aim: To determine the effect of a mental health intervention comprising a mindfulness program for promoting well-being, reducing stress, and increasing competence in mental health self-management. This is the first study among athletes to test the mechanisms of change in a mindfulness program using Self-Determination Theory (SDT). Methods: A 2 (groups) × 2 (time-point) non-randomized controlled trial was conducted, and between-groups baseline differences were firstly assessed. Two competing regression models assessing singular and serial indirect mediating mechanisms were conducted, in which mindfulness (Model 1) and competence satisfaction (Model 2) were both tested as primary and secondary mediators predicting change scores in stress and well-being. Demographic variables (i.e., gender, age) were controlled for in the analyses. Results: Two hundred and thirty-eight student athletes (mean age = 20.47 years, SD = 3.30, 57.6% = males) participated, with 108 in the intervention group who received an instructional workshop, and a home-directed mindfulness program comprising daily meditation sessions. No baseline differences were found between intervention and control groups. In Model 1, mindfulness was not directly enhanced by the intervention, subsequently resulting in no indirect effects on competence, stress and well-being. In Model 2, the intervention was directly related to positive changes in competence (β = 0.39, p < 0.05), subsequently resulting in indirect effects on mindfulness awareness (β = 0.07, p < 0.05), stress (β = -0.06, p < 0.05), and well-being (β = 0.05, p < 0.05). In addition, serial indirect effects for the intervention on stress were present through competence and mindfulness awareness in sequence (β = -0.02, p < 0.05), and; on well-being through competence, mindfulness awareness, and stress in sequence (β = 0.01, p < 0.05; R 2 = 0.54). Conclusion: Mindfulness-based mental health interventions may be effective at reducing stress and promoting well-being in athletes, with the caveat that attention is given to the inclusion of mental health competence promotion in program design. However, it remains unclear whether increasing mindfulness itself can exert additional salutary effects. Our findings have an important bearing on how mindfulness programs are developed within athlete mental health interventions.