Department of Sports Science and Clinical Biomechanics, Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
Department of Sports Science and Clinical Biomechanics, Research Unit for Musculoskeletal Function and Physiotherapy, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark; Department of Occupational Therapy and Physiotherapy, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark.
Health Place. 2024 Sep;89:103333. doi: 10.1016/j.healthplace.2024.103333. Epub 2024 Aug 19.
This systematic review and meta-analysis summarizes the effectiveness of school-based physical activity (PA) interventions on children's and adolescents' PA. As no robust empirical evidence exists regarding what seems to characterize the school-based PA interventions that are most effective, we further aimed to map key factors of particular importance when trying to increase PA in early stages of life through school-based strategies. Intervention effects were calculated as standardized between-group (i.e., intervention vs. control) mean differences (SMD) in PA from baseline to follow-up. In total, 189 publications were included. Few studies (7%) were of high quality. Our results demonstrate that school-based interventions only have a small positive effect on children's and adolescents' PA levels. Compared to the effect observed during total day (SMD = 0.27, p < 0.001), a slightly larger effect was observed during school hours (SMD = 0.37, p < 0.001), while no intervention effect was observed during leisure time (SMD = 0.07, p = 0.20). There was a tendency for interventions to be more effective if theoretical frameworks for behavior changes were used in the design phase. The largest effect size was observed when experts from outside school delivered the program (SMD = 0.56, p = 0.01), but training of personnel involved in delivery was the determining factor for program effectiveness as no effect was observed if interventions were delivered primarily by schools' untrained staff (SMD = 0.06, p = 0.61). Intervention effects where larger if parents were involved in the intervention program (parents involved: SMD = 0.35, p < 0.001; parents not involved: SMD = 0.16, p = 0.02). Small positive intervention effects were sustained at long-term follow-up after end of intervention. Overall, the certainty of the evidence of the findings is rated as low.
本系统评价和荟萃分析总结了基于学校的身体活动（PA）干预对儿童和青少年 PA 的有效性。由于目前还没有关于哪些因素似乎是最有效的基于学校的 PA 干预的强有力的实证证据，我们进一步旨在绘制关键因素图，这些因素在通过基于学校的策略在生命早期阶段增加 PA 时非常重要。干预效果计算为从基线到随访期间 PA 的标准化组间（即干预与对照）平均差异（SMD）。总共纳入了 189 篇出版物。很少有研究（7%）质量较高。我们的研究结果表明，基于学校的干预措施对儿童和青少年的 PA 水平只有微小的积极影响。与全天观察到的效果（SMD=0.27，p<0.001）相比，在上课时间观察到的效果稍大（SMD=0.37，p<0.001），而在闲暇时间观察到的效果则没有（SMD=0.07，p=0.20）。如果在设计阶段使用行为改变的理论框架，则干预措施更有可能有效。当学校外的专家提供方案时，观察到的效果最大（SMD=0.56，p=0.01），但参与交付的人员的培训是方案有效性的决定因素，因为如果干预主要由学校未经培训的人员交付，则没有观察到效果（SMD=0.06，p=0.61）。如果家长参与干预计划，则干预效果更大（家长参与：SMD=0.35，p<0.001；家长不参与：SMD=0.16，p=0.02）。在干预结束后的长期随访中，干预的积极效果持续存在。总体而言，研究结果的证据确定性被评为低。
