Stone E J, McKenzie T L, Welk G J, Booth M L
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, Maryland 20892-7936, USA.
Am J Prev Med. 1998 Nov;15(4):298-315. doi: 10.1016/s0749-3797(98)00082-8.
Physical inactivity has been identified as an important public health concern for youth. School and community settings can be important infrastructures for promoting physical activity (PA). This paper reviews studies of physical activity in school and community settings among preschool through college-aged persons to determine characteristics and effects of interventions. Studies in progress are included.
Studies from 1980 to 1997 testing physical activity interventions in schools and community settings were identified by computerized search methods and reference lists of published reviews. Studies needed to have used a quantitative assessment of PA, used a comparison or control group, included participants who were preschool through college age, and be conducted in the United States or foreign school or community settings. Significance of effects was examined overall and for various types of interventions.
Twenty-two school-based studies were reviewed, 14 completed and 8 in progress. Three studies were in countries other than the United States. The 8 studies in progress were all in the United States. Only 7 community studies were reviewed, all in the United States. Four studies were in progress. Several community studies involved a high percentage of African-American or Hispanic youth and their families. Studies showing the best results used randomized designs, valid and reliable measurements, and more extensive interventions. Some follow-up results showed PA was sustained after interventions ended.
The collection of school and community studies is limited for several age groups with none below third grade and only three at college age. There are few community studies. The most is known about upper-elementary-age-students, including the first multicenter randomized trial to report significant results for increasing moderate to vigorous physical activity (MVPA) in physical education (PE) and increase vigorous PA outside of school. A number of older study designs were weak and assessments less than optimal, but studies in progress are stronger. Special attention is needed for girls, middle schools, and community settings for all youth. More objective assessments are needed for measuring PA outside of school and in younger children, since they cannot provide reliable self-report.
缺乏体育活动已被视为青少年重要的公共卫生问题。学校和社区环境可能是促进体育活动（PA）的重要基础设施。本文回顾了针对学龄前至大学年龄段人群在学校和社区环境中进行体育活动的研究，以确定干预措施的特点和效果。正在进行的研究也包括在内。
通过计算机检索方法和已发表综述的参考文献列表，确定了1980年至1997年期间在学校和社区环境中测试体育活动干预措施的研究。研究需对体育活动进行定量评估，设有比较组或对照组，纳入学龄前至大学年龄段的参与者，并在美国或国外的学校或社区环境中进行。总体及各类干预措施的效果显著性均进行了检验。
回顾了22项基于学校的研究，其中14项已完成，8项正在进行。3项研究在非美国的国家进行。正在进行的8项研究均在美国。仅回顾了7项社区研究，均在美国。4项研究正在进行。几项社区研究涉及高比例的非裔美国或西班牙裔青少年及其家庭。显示出最佳结果的研究采用了随机设计、有效且可靠的测量方法以及更广泛的干预措施。一些随访结果表明，干预结束后体育活动得以持续。
针对几个年龄组的学校和社区研究数量有限，三年级以下的年龄组没有相关研究，大学年龄组仅有三项研究。社区研究很少。对小学高年级学生的了解最多，包括首个多中心随机试验，该试验报告了在体育课中增加中度至剧烈体育活动（MVPA）以及在校外增加剧烈体育活动方面取得显著成果。许多早期的研究设计存在缺陷，评估也不尽如人意，但正在进行的研究更为完善。对于女孩、中学以及所有青少年的社区环境，需要给予特别关注。由于年幼孩子无法提供可靠的自我报告，因此在测量校外体育活动和年幼儿童的体育活动时，需要更客观的评估方法。
