scholarly journals Comparative effectiveness of school‐based interventions targeting physical activity, physical fitness or sedentary behaviour on obesity prevention in 6‐ to 12‐year‐old children: A systematic review and meta‐analysis

2021 ◽  
Vol 22 (2) ◽  
Author(s):  
Hrvoje Podnar ◽  
Petra Jurić ◽  
Josip Karuc ◽  
Marc Saez ◽  
Maria A. Barceló ◽  
...  
Author(s):  
Zheng Liu ◽  
Han-Meng Xu ◽  
Li-Ming Wen ◽  
Yuan-Zhou Peng ◽  
Li-Zi Lin ◽  
...  

Abstract Background Childhood obesity is a serious public health concern. School-based interventions hold great promise to combat the rising trend of childhood obesity. This systematic review aimed to assess the overall effects of school-based obesity prevention interventions, and to investigate characteristics of intervention components that are potentially effective for preventing childhood obesity. Methods We systematically searched MEDLINE, CENTRAL and Embase databases to identify randomized- or cluster randomized- controlled trials of school-based obesity interventions published between 1990 and 2019. We conducted meta-analyses and subgroup analyses to determine the overall effects of obesity prevention programs and effect differences by various characteristics of intervention components on body mass index (BMI) or BMI Z-score of children. Results This systematic review included a total of 50 trials (reported by 56 publications). Significant differences were found between groups on BMI (− 0.14 kg/m2 (95% confidence interval: − 0.21, − 0.06)) and BMI Z-score (− 0.05 (− 0.10, − 0.01)) for single-component interventions; significant differences were also found between groups on BMI (− 0.32 (− 0.54, − 0.09) kg/m2) and BMI Z-score (− 0.07 (− 0.14, − 0.001)) for multi-component interventions. Subgroup analyses consistently demonstrated that effects of single-component (physical activity) interventions including curricular sessions (− 0.30 (− 0.51, − 0.10) kg/m2 in BMI) were stronger than those without curricular sessions (− 0.04 (− 0.17, 0.09) kg/m2 in BMI); effects of single-component (physical activity) interventions were also strengthened if physical activity sessions emphasized participants’ enjoyment (− 0.19 (− 0.33, − 0.05) kg/m2 in BMI for those emphasizing participants’ enjoyment; − 0.004 (− 0.10, 0.09) kg/m2 in BMI for those not emphasizing participants’ enjoyment). The current body of evidence did not find specific characteristics of intervention components that were consistently associated with improved efficacy for multi-component interventions (P > 0.05). Conclusions School-based interventions are generally effective in reducing excessive weight gain of children. Our findings contribute to increased understandings of potentially effective intervention characteristics for single-component (physical activity) interventions. The impact of combined components on effectiveness of multi-component interventions should be the topic of further research. More high-quality studies are also needed to confirm findings of this review.


2019 ◽  
Vol 50 (3) ◽  
pp. 543-560 ◽  
Author(s):  
Ashley Cox ◽  
Stuart J. Fairclough ◽  
Maria-Christina Kosteli ◽  
Robert J. Noonan

Abstract Background It has been reported that boys’ and girls’ physical activity (PA) levels decline throughout adolescence. Boys are at risk of physical inactivity during adolescence; however, in intervention research, they are an under-represented group relative to girls. It is suggested that the school environment may be central to developing interventions that support adolescents in meeting the current PA guidelines. The aim of this systematic review and meta-analysis was to investigate the efficacy of school-based physical activity interventions for improving muscular fitness (MF) in adolescent males. Methods This systematic review and meta-analysis followed the preferred reporting systems for meta-analyses guidelines and was registered on PROSPERO (Registration number: CRD42018091023). Eligible studies were published in English within peer-reviewed articles. Searches were conducted in three databases, with an additional grey literature search in Google Scholar. Studies investigating MF outcomes were included. Results There were 43 data sets identified across 11 studies, from seven countries. Overall methodological quality of the studies was moderate-to-strong. Interventions targeting MF evidenced a small-to-medium effect (g = 0.32, CI 0.17, 0.48, p < 0.00). Subgroup analyses of MF delivery method resulted in small-to-medium effects: upper limb MF measures (g = 0.28, 95% CI − 0.02, 0.58, p = 0.07), lower limb MF measures (g = 0.28, 95% CI 0.09, 0.68, p = 0.03), combined MF activities (g = 0.24, 95% CI − 0.04 to 0.49, p = 0.05), plyometric activities (g = 0.39, 95% CI 0.09, 0.68, p = 0.01), body weight (g = 0.27, 95% CI − 0.10, 0.65, p = 0.15), and traditional MF methods (g = 0.43, 95% CI 0.09, 0.78, p = 0.01). Conclusions School-based interventions which aimed to increase MF outcomes in adolescent boys demonstrated small-to-moderate effects. Traditional and plyometric methods of resistance training appear to be the most effective form of PA delivery in adolescent males. More quality research is required to assess the impact of MF delivered in the school environment to inform future intervention design.


Author(s):  
Annegret Schlund ◽  
Anne K. Reimers ◽  
Jens Bucksch ◽  
Stephanie Linder ◽  
Yolanda Demetriou

AbstractPhysical inactivity is an increasing problem worldwide, but especially among girls. This difference by gender increases with age. Schools serve virtually all young people in most parts of the world and can thus play an important role in promoting physical activity. In this systematic review, we qualitatively and comprehensively assessed the treatment of sex/gender considerations (from study design to discussion of results) in 56 school-based intervention studies aiming to promote physical activity in children and adolescents. In all 56 studies, the factor of sex/gender was only rudimentarily considered, regardless of the effectiveness of the intervention. The meta-analysis revealed that the interventions had significant but relatively small effects with both girls and boys, along with high heterogeneity. To obtain better information about effective strategies that promote physical activity for both girls and boys equally, researchers conducting future intervention studies should pay attention to sex/gender differences and report on how they take this factor into account.


2019 ◽  
Author(s):  
Ashley Cox ◽  
Stuart J. Fairclough ◽  
Maria-Christina Kosteli ◽  
Robert J. Noonan

Background: It has been reported that boys’ and girls’ physical activity (PA) levels decline throughout adolescence. Boys are at risk of physical inactivity during adolescence however, in intervention research they are an under-represented group relative to girls. It is suggested that the school environment may be central to developing interventions that support adolescents in meeting the current PA guidelines. The purpose of this systematic review and meta-analysis was to investigate the efficacy of school-based interventions to increase moderate to vigorous physical activity (MVPA) and muscle and bone strengthening exercise (MBSE) outcomes in adolescent males. Methods: This systematic review and meta-analysis followed the preferred reporting systems for meta-analyses guidelines and was registered on PROSPERO (Registration number: CRD42018091023). Eligible studies were published in English within peer-reviewed articles. Searches were conducted in three databases, with an additional grey literature search in Google Scholar. Studies with MVPA and MBSE as outcomes were included.Results: There were 51 data sets identified across 15 studies, from eight countries. Overall methodological quality of the studies was moderate to strong. Significant, small effect sizes were identified following a pooled analysis of all studies which aimed to increase MVPA and MBSE outcomes (g = 0.26, 95% CI = 0.15, 0.37, P = &lt;.001). Interventions targeting MVPA were ineffective (g = -0.09, 95% CI -0.72, -0.53, P = 0.77). Interventions targeting MBSE evidenced a small to medium effect (g = 0.27, CI 0.16, 0.39, P = &lt;.001). Sub-group analyses of MBSE delivery method resulted in small to medium effects: Upper limb MBSE (g = 0.23, 95% CI 0.03, 0.43, p = 0.02), lower limb MBSE (g = 0.21, 95% CI 0.09, 0.33, p &lt;0.00), combined resistance activities (g = 0.22, 95% CI 0.05 – 0.39, p = &lt;0.00), plyometric activities (g = 0.39, 95% CI 0.09, 0.68, p = 0.01), body weight (g = 0.21, 95% CI -0.00, 0.44, p = 0.05), and traditional MBSE methods (g = 0.43, 95% CI -0.09, 0.78, p = 0.01).Conclusions: School-based interventions which aim to increase MVPA in adolescent males were not effective. Interventions focused on MBSE demonstrated small to moderate effects. Traditional and plyometric methods of MBSE appear to be the most effective form of PA delivery in adolescent males. More quality research is required to assess the impact of MBSE delivered in the school environment in order to inform future intervention design.


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