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Journal ArticleDOI

School-Based Physical Activity Interventions: Effectiveness, Trends, Issues, Implications and Recommendations for Practice.

01 Jan 2006-Sport Education and Society (Routledge)-Vol. 11, Iss: 4, pp 401-420
TL;DR: It is acknowledged that the existing literature is not sufficiently extensive to provide definitive guidelines for schools, and the implications for practice are considered and recommendations for future physical activity programmes, initiatives and interventions are presented.
Abstract: The promotion of physical activity within schools and physical education (PE) has attracted growing interest in recent years. Schools have been acknowledged as the primary institution with responsibility for promoting activity in young people and more specifically, school PE has been recognized as having a key role to play. Given this, and based on previous reviews of the findings of formally evaluated interventions, this paper considers the evidence for the effectiveness of school-based physical activity interventions and highlights the key trends and a number of issues concerning their type, target population, design, implementation and content. Earlier reviews have provided comprehensive summaries of the effectiveness of physical activity interventions but they have not provided specific guidance for teachers’ practice in schools. Thus, whilst it is acknowledged that the existing literature is not sufficiently extensive to provide definitive guidelines for schools, this paper considers the implications...

Summary (1 min read)

Implications and recommendations for practice

  • Whilst most schools are unlikely to be involved in the large scale formal and more ‘robust’ research studies reviewed within this paper, they are likely to be involved in planning and implementing health-related or physical activity programmes or initiatives with young people with the aim of increasing their physical activity levels.
  • Furthermore, the evidence on the effectiveness of school based interventions suggests that teachers’ efforts to plan and implement programmes can be worthwhile.
  • On the basis of the studies to date however, Fox and Harris (2003), concluded that the existing literature is not sufficiently extensive to provide definitive guidelines for schools about which types or aspects of programmes are most effective in promoting activity.
  • These are presented in table 1. Insert Table 1 here.

Conclusion

  • The evidence reviewed here has revealed that school based physical activity interventions can be effective and achieve a range of positive outcomes, suggesting that teachers’ efforts to promote physical activity through PE programmes can indeed be worthwhile.
  • Until a stronger evidence base becomes available, schools and teachers should be encouraged to plan, implement and evaluate programmes and draw on such recommendations to inform their practice.

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School based physical activity interventions – effectiveness, trends,
issues, implications and recommendations for practice
Lorraine Cale and Jo Harris
School of Sport and Exercise Sciences
Loughborough University
Loughborough
LE 11 3TU
Tel: 01509 226302
Fax: 01509 226301
Correspondence to:
Lorraine Cale at the above address
L.A.Cale@lboro.ac.uk

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Abstract
The promotion of physical activity within schools and Physical Education
(PE) has attracted growing interest in recent years. Schools have been
acknowledged as the primary institution with responsibility for promoting
activity in young people and more specifically, school PE has been
recognized as having a key role to play. Given this, and based on previous
reviews of the findings of formally evaluated interventions, this paper
considers the evidence for the effectiveness of school based physical activity
interventions and highlights the key trends and a number of issues
concerning their type, target population, design, implementation and content.
Earlier reviews have provided comprehensive summaries of the
effectiveness of physical activity interventions but they have not provided
specific guidance for teachers’ practice in schools. Thus, whilst it is
acknowledged that the existing literature is not sufficiently extensive to
provide definitive guidelines for schools, this paper considers the
implications for practice and presents recommendations for future physical
activity programmes, initiatives and interventions.
Introduction
Given the growing concerns over the physical activity levels of many young
people and the possible health consequences, targeted efforts to promote
physical activity would seem to be warranted. In this respect, the promotion
of physical activity within schools and the physical education (PE) curriculum
has attracted growing interest in recent years. Schools have been
acknowledged as the primary institution with responsibility for promoting

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activity in young people (Cardon and Bourdeaudhuij, 2002; McBride and
Midford, 1999; Sallis and Owen, 1999). More specifically, school PE has
been recognized as having a key role to play (see for example, Armstrong
2002; Cale, 2000a; Cardon and Bourdeaudhuij, 2002; McKenzie, 2001;
Shephard and Trudeau, 2000). Indeed, McKenzie (2001) views PE as the
most suitable vehicle for the promotion of active, healthy lifestyles among
young people. According to Stone and colleagues (1998), school based
physical activity interventions have an inherent advantage over interventions
in other settings because programmes can become institutionalized into the
regular school curriculum, staff development and other infrastructures. It is
perhaps not surprising therefore, that they are the most common form of
physical activity intervention with young people.
Furthermore, the role of schools and PE in promoting health and the link
between health and education has increasingly been recognized by
Government in the United Kingdom (UK). Harris and Penney (2000, p. 252)
note how official and semi official pronouncements on behalf of Government
have clearly identified PE as ‘critical in educating and providing opportunities
for young people to become independently active for life,’ whilst Green
(2004) reports that the encouragement of lifelong participation in sport and
physical activity is an implicit and explicit theme in government policy
towards health promotion generally and PE and sport in schools in
particular. This is evidenced in a number of publications in recent years that
have attested to the desirability of utilizing schools and PE in order to
promote lifelong participation in sport and physical activity (e.g., Department

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for Culture, Media and Sport (DCMS), 2001; Department of Health (DoH),
1999; 2005a; 2005b; DCSM London Strategy Unit, 2002). Perhaps the most
recent and significant example of this was the launch of the National PE,
School Sport and Club Links Strategy in October 2002, which is being
delivered by the Department for Education and Skills (DfES) and DCMS and
being supported by a Government investment of £459 million over three
years. The aim of the strategy is to:
‘increase the percentage of school children in England who spend a
minimum of two hours each week on high quality PE and school sport
within and beyond the curriculum (from 25 per cent in 2002) to 75 per
cent by 2006.’ (DfES, 2003, p.2).
In December 2004, a further £519 million was allocated to continue and build
on the Strategy from 2006/07 to 2007/08, to extend the target to 85 per cent
of children spending at least two hours a week on high quality PE and school
sport by 2008 (DfES, 2004).
This interest and level of investment is perhaps being fuelled by concerns
generally over young people’s health and more recently by the alleged
‘obesity epidemic’ and ‘alarming’ rise in childhood obesity, as well as by the
general acceptance of a biomedical model of health as an appropriate
response and means of intervention (Johns, 2005). Yet interestingly, the
‘obesity discourse,’ with its inherent uncertainties, ambiguities and conflicts
of knowledge has been critiqued and contested elsewhere, as has the
uncritical acceptance of PE’s role in the prevention or treatment of obesity

Citations
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TL;DR: In this paper, a systematic review was performed summarizing the research conducted to date regarding the effectiveness of after-school programs in increasing physical activity, and positive effect sizes were demonstrated for physical activity.

272 citations

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TL;DR: In this paper, the authors explored the key issues, concerns and debates regarding fitness testing, as they relate to encouraging a physically active lifestyle, and found that one of the key purposes of testing to be the promotion of healthy lifestyles and physical activity.
Abstract: Background: Physical fitness testing is commonplace within schools and the physical education (PE) curriculum, with advocates claiming one of the key purposes of testing to be the promotion of healthy lifestyles and physical activity. Despite this, much controversy has surrounded the fitness testing of young people. Purpose: This paper draws on selected findings of a recent ‘fitness testing children feasibility study’ to explore the key issues, concerns and debates regarding fitness testing, as they relate to encouraging a physically active lifestyle. Research design: The feasibility study was commissioned by the National Assembly for Wales and involved two main parts: a comprehensive review of the literature (using metalib) to establish the key findings/issues, and consultation with key ‘stakeholders’ and ‘experts’ to ascertain their views, understanding and experiences of fitness testing children. The consultation was carried out via questionnaires and interviews. Data analysis: The key issues and theme...

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Journal ArticleDOI
TL;DR: The results of the present study provide further evidence that physical activity monitoring using pedometers is an effective strategy for increasing activity among low-active adolescents.
Abstract: The purpose of this study was to evaluate the impact of an extra-curricular school sport programme to promote physical activity among adolescents. One hundred and sixteen students (mean age 14.2 years, s = 0.5) were assigned to an intervention (n = 50) or comparison group (n = 66). The 8-week intervention involved structured exercise activities and information sessions. Four days of pedometer monitoring and time spent in non-organized physical activity and sedentary behaviours were measured at baseline and post-test. At baseline, participants were classified using steps per day as low-active (girls <11,000, boys <13,000) or active (girls ≥ 11,000, boys ≥ 13,000) and the effects of the intervention were assessed using these subgroups. Adolescents in the intervention group classified as low-active at baseline increased their step counts across the 8-week intervention (baseline: 7716 steps/day, s = 1751; post-test: 10,301 steps/day, s = 4410; P < 0.05) and accumulated significantly more steps (P < 0...

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Cites background from "School-Based Physical Activity Inte..."

  • ...First, most school-based physical activity interventions have involved the evaluation of modified healthrelated physical education (PE) with limited longterm impact (Cale & Harris, 2006; Timperio, Salmon, & Ball, 2004)....

    [...]

  • ...Although there is empirical support for the effectiveness of school-based programmes in promoting physical activity among youth (Cale & Harris, 2006; Kahn et al., 2002; Stone, McKenzie, Welk, & Booth, 1998), two criticisms of previous interventions have been noted in the literature....

    [...]

Journal ArticleDOI
TL;DR: The PALs program was a feasible and efficacious approach to induce healthy weight loss in adolescent boys from disadvantaged secondary schools and reduced their consumption of sugar-containing beverages.

86 citations

01 Jan 2000
TL;DR: In this paper, it has been shown that unhealthy health behaviors adopted early in life may negatively influence health in adulthood by having both a short-term effect on physiological risk factors and a long-term impact on health behavior.
Abstract: In recent years a compelling body of knowledge has been accumulated to support the belief that physical activity and dietary behaviors carry important health consequences for young people It has long been known that adequate nutrition and physical activity are essential for normal growth and development [1] Recently, however, clear evidence has emerged that diet and physical activity during childhood and adolescence also affect an array of physiological factors associated with risk for developing chronic diseases; these factors include body composition (eg, adiposity), blood lipid concentrations, blood pressure, and bone mineral density It also appears that physical activity and dietary behaviors and the physiological outcomes associated with them often track from childhood and adolescence into adulthood Thus, risky health behaviors adopted early in life may negatively influence health in adulthood by having both a short-term effect on physiological risk factors and a long-term impact on health behavior

77 citations

References
More filters
Journal ArticleDOI
27 Oct 1999-JAMA
TL;DR: In this article, the effects of reducing television, videotape, and video game use on changes in adiposity, physical activity, and dietary intake were evaluated in a randomized controlled school-based trial.
Abstract: ContextSome observational studies have found an association between television viewing and child and adolescent adiposity.ObjectiveTo assess the effects of reducing television, videotape, and video game use on changes in adiposity, physical activity, and dietary intake.DesignRandomized controlled school-based trial conducted from September 1996 to April 1997.SettingTwo sociodemographically and scholastically matched public elementary schools in San Jose, Calif.ParticipantsOf 198 third- and fourth-grade students, who were given parental consent to participate, 192 students (mean age, 8.9 years) completed the study.InterventionChildren in 1 elementary school received an 18-lesson, 6-month classroom curriculum to reduce television, videotape, and video game use.Main Outcome MeasuresChanges in measures of height, weight, triceps skinfold thickness, waist and hip circumferences, and cardiorespiratory fitness; self-reported media use, physical activity, and dietary behaviors; and parental report of child and family behaviors. The primary outcome measure was body mass index, calculated as weight in kilograms divided by the square of height in meters.ResultsCompared with controls, children in the intervention group had statistically significant relative decreases in body mass index (intervention vs control change: 18.38 to 18.67 kg/m2 vs 18.10 to 18.81 kg/m2, respectively; adjusted difference −0.45 kg/m2 [95% confidence interval {CI}, −0.73 to −0.17]; P=.002), triceps skinfold thickness (intervention vs control change: 14.55 to 15.47 mm vs 13.97 to 16.46 mm, respectively; adjusted difference, −1.47 mm [95% CI, −2.41 to −0.54]; P=.002), waist circumference (intervention vs control change: 60.48 to 63.57 cm vs 59.51 to 64.73 cm, respectively; adjusted difference, −2.30 cm [95% CI, −3.27 to −1.33]; P<.001), and waist-to-hip ratio (intervention vs control change: 0.83 to 0.83 vs 0.82 to 0.84, respectively; adjusted difference, −0.02 [95% CI, −0.03 to −0.01]; P<.001). Relative to controls, intervention group changes were accompanied by statistically significant decreases in children's reported television viewing and meals eaten in front of the television. There were no statistically significant differences between groups for changes in high-fat food intake, moderate-to-vigorous physical activity, and cardiorespiratory fitness.ConclusionsReducing television, videotape, and video game use may be a promising, population-based approach to prevent childhood obesity.

1,980 citations

Journal ArticleDOI
TL;DR: In this article, the Guide to Community Preventive Service's methods for systematic reviews were used to evaluate the effectiveness of various approaches to increasing physical activity: informational, behavioral and social, and environmental and policy approaches.

1,866 citations

Journal ArticleDOI
TL;DR: Current trends in food supply, eating out, physical activity, and inactivity are reviewed, as are the effects of advertising, promotion, and pricing on eating and physical activity.
Abstract: ▪ Abstract Obesity has increased dramatically over the past two decades and currently about 50% of US adults and 25% of US children are overweight. The current epidemic of obesity is caused largely by an environment that promotes excessive food intake and discourages physical activity. This chapter reviews what is known about environmental influences on physical activity and eating behaviors. Recent trends in food supply, eating out, physical activity, and inactivity are reviewed, as are the effects of advertising, promotion, and pricing on eating and physical activity. Public health interventions, opportunities, and potential strategies to combat the obesity epidemic by promoting an environment that supports healthy eating and physical activity are discussed.

1,533 citations


"School-Based Physical Activity Inte..." refers background in this paper

  • ...However, despite growing support for the ecological perspective, French et al. (2001) note that environmental and policy interventions are the least studied component of school health promotion....

    [...]

01 Jan 1999
TL;DR: In this article, Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education, focusing on decreasing television viewing, decreasing consumption of high-fat foods, increasing fruit and vegetable intake, and increasing moderate and vigorous physical activity.
Abstract: Intervention: Students participated in a school-based interdisciplinary intervention over 2 school years. Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education. Sessions focused on decreasing television viewing, decreasing consumption of high-fat foods, increasing fruit and vegetable intake, and increasing moderate and vigorous physical activity.

1,359 citations

Journal ArticleDOI
TL;DR: Planet Health decreased obesity among female students, indicating a promising school-based approach to reducing obesity among youth.
Abstract: Objective To evaluate the impact of a school-based health behavior intervention known as Planet Health on obesity among boys and girls in grades 6 to 8. Design Randomized, controlled field trial with 5 intervention and 5 control schools. Outcomes were assessed using preintervention (fall 1995) and follow-up measures (spring 1997), including prevalence, incidence, and remission of obesity. Participants A group of 1295 ethnically diverse grade 6 and 7 students from public schools in 4 Massachusetts communities. Intervention Students participated in a school-based interdisciplinary intervention over 2 school years. Planet Health sessions were included within existing curricula using classroom teachers in 4 major subjects and physical education. Sessions focused on decreasing television viewing, decreasing consumption of high-fat foods, increasing fruit and vegetable intake, and increasing moderate and vigorous physical activity. Main Outcome Measures Obesity was defined as a composite indicator based on both a body mass index and a triceps skinfold value greater than or equal to age- and sex-specific 85th percentiles. Because schools were randomized, rather than students, the generalized estimating equation method was used to adjust for individual-level covariates under cluster randomization. Results The prevalence of obesity among girls in intervention schools was reduced compared with controls, controlling for baseline obesity (odds ratio, 0.47; 95% confidence interval, 0.24-0.93; P = .03), with no differences found among boys. There was greater remission of obesity among intervention girls vs control girls (odds ratio, 2.16; 95% confidence interval, 1.07-4.35; P = .04). The intervention reduced television hours among both girls and boys, and increased fruit and vegetable consumption and resulted in a smaller increment in total energy intake among girls. Reductions in television viewing predicted obesity change and mediated the intervention effect. Among girls, each hour of reduction in television viewing predicted reduced obesity prevalence (odds ratio, 0.85; 95% confidence interval, 0.75-0.97; P = .02). Conclusion Planet Health decreased obesity among female students, indicating a promising school-based approach to reducing obesity among youth.

1,299 citations


"School-Based Physical Activity Inte..." refers background in this paper

  • ...Programme outcomes Design programme outcomes that are realistic, focus on behavioural (physical activity levels), cognitive (knowledge and understanding) and affective (attitude) changes, and that meet, complement and reinforce National Curriculum requirements and the outcomes identified by Harris (2000). . Design Adopt an ecological approach to the intervention design. Include multi-component interventions (e.g. which focus on the school curriculum, the PE curriculum, parents/families and out-of-school activity) and multiple levels of influence (e.g. interpersonal, intrapersonal, policy, environment). Where appropriate, also consider employing interventions which target multiple health behaviours (e.g. physical activity alongside diet, relaxation, stress management). . Content Design programme content to meet, complement and reinforce National Curriculum requirements and the outcomes and the philosophy outlined by Harris (2000). ....

    [...]

  • ...Programme outcomes Design programme outcomes that are realistic, focus on behavioural (physical activity levels), cognitive (knowledge and understanding) and affective (attitude) changes, and that meet, complement and reinforce National Curriculum requirements and the outcomes identified by Harris (2000). ....

    [...]

Frequently Asked Questions (16)
Q1. What are the contributions in this paper?

In this paper, the authors evaluate the effectiveness of PE and sport interventions in the UK and conclude that PE is the most suitable vehicle for the promotion of active, healthy lifestyles among young people. 

Further, and despite limitations in the existing literature precluding definitive guidelines for schools to be made, consideration of the key trends and issues concerning the physical activity interventions clearly has implications for practice and has been used to inform a number of recommendations for the future direction of formal and informal physical activity programmes, initiatives and interventions. 

Another important reason for moving beyond the curriculum relates to the limitations of healthism and the biomedical discourse upon which curriculum based interventions are based. 

Given that physical activity levels decrease with age, particularly during the teenage years (Armstrong and Van Mechelen, 1998; Riddoch and Boreham, 1995), the lack of secondary based interventions is disappointing. 

For interventions to be critically evaluated, clearly defined and measurable goals are needed that are based on the best available evidence defining valued outcomes. 

The most common theory was the Social Cognitive Theory or Social Learning Theory, though Social Influences, Self-Monitoring, Cognitive Evaluation Theory (self-regulation) and Organizational Change Theory were also employed. 

Twenty four middle schools were randomly assigned to interventionor control conditions and physical activity interventions designed to increase physical activity in PE classes and throughout the school day were carried out over two years. 

The aim of the strategy is to:‘increase the percentage of school children in England who spend a minimum of two hours each week on high quality PE and school sport within and beyond the curriculum (from 25 per cent in 2002) to 75 per cent by 2006.’ 

Stone et al., (1998) suggest that the absence of pre-school and early primary years in interventions is partially due to the difficulty in measuring physical activity, as well as delivering interventions with these groups. 

Perhaps the most recent and significant example of this was the launch of the National PE, School Sport and Club Links Strategy in October 2002, which is being delivered by the Department for Education and Skills (DfES) and DCMS and being supported by a Government investment of £459 million over three years. 

Some researchers consider the use of random assignment and control groups a necessity in intervention research, whilst others consider such experimental examinations an impossibility (Kemper, 1990). 

Harris and Cale (1997) on the other hand, suggest that the predominance of primary school programmes may be due to the increased flexibility generally afforded by the primary curriculum and to their more generally holistic approach to health education. 

Tinning and Kirk (1991) highlight the limitations of adopting a scientifically based experimental approach within complex social settings such as schools and identified problems with the matching of control and experimental groups and of isolating the effects of programmes from control groups. 

Ecological approaches have, at their core, the notion that behaviour, in this case physical activity, is influenced by multiple facets of the intrapersonal (e.g., psychological and biological variables, developmental history), interpersonal (e.g., family, peers), and physical and policy and legislative environments (Gorely, 2005). 

Compatible with the NCPE health and fitness requirements and the interpretation offered by Harris (2000) is the notion of ‘lifelong or lifetime physical activity,’ which suggests that content should focus on the development of activities and skills ‘that promote generalization and maintenance of physical activity during youth and adolescence and enhance the probability of carryover to adulthood’ 

The evidence reviewed here has revealed that school based physical activity interventions can be effective and achieve a range of positive outcomes,suggesting that teachers’ efforts to promote physical activity through PE programmes can indeed be worthwhile.