Effects of school-based interventions on motivation towards physical activity in children and adolescents: A systematic review and meta-analysis

IntroductionAssuming that motivation is the key to initiate and sustain beneficial health behaviors, the aim of this systematic review was to analyze the effects of school-based physical activity interventions on a variety of motivational outcomes towards PA in school-aged children and adolescents.MethodsA comprehensive literature search was carried out in six electronic databases to identify randomized controlled trials and quasi-experimental trials examining the effects of PA interventions implemented during the regular school day, e.g., during physical education lessons or lunch breaks. Primary outcomes of interest were students' motivation, basic psychological needs, goal orientation, enjoyment, and motivational teaching climate in physical education. Meta-analyses were conducted for these outcomes using Comprehensive Meta-analysis software. Secondarily, intervention effects on students' PA behaviors were examined and the findings summarized narratively. Methodological quality of studies was evaluated using the Cochrane Collaboration's tool for assessing risk of bias for randomized trials; certainty of evidence on outcome level was evaluated using the GRADE approach.ResultsIn total, 57 studies carried out between 2001 and 2018 were included in this review. Sixteen individual meta-analyses were performed and revealed significant pooled effects for the outcomes enjoyment (g = 0.310), perceived autonomy (g = 0.152), identified regulation (g = 0.378), intrinsic motivation (g = 0.419), self-determination index (g = 0.672), task/mastery climate (g = 0.254), ego/performance climate (g = −0.438), autonomy supportive climate (g = 0.262), task goal orientation (g = 1.370), ego goal orientation (g = −0.188). The narrative data synthesis indicated an increase in students' PA behavior. The overall risk of bias was high across all studies and certainty of evidence of meta-analyzed outcomes ranged from very low to moderate. Moderate certainty of evidence was found for ego/performance climate and ego goal orientation. Conclusions: Meta-analyses suggest that school-based PA interventions may be effective in increasing a variety of motivational outcomes. However, the certainty of evidence was limited in the majority of outcomes. Further research is needed to identify effective intervention strategies that increase students’ motivation towards PA.     

A Classroom-Based Physical Activity Intervention for Elementary Student On-Task Behavior

Few youths engage in the recommended amount of physical activity (PA). Many educators have concerns about increasing PA in schools, including taking time from academics, though studies show that school-based PA can be beneficial to academics. This study extends previous research on the relationship between school-based PA and time on task (TOT) by engaging students in teacher-led PA breaks in the classroom and observing students' on-task behavior for a longer period than previous studies. A third-grade class of 23 students from a rural New England public school was observed as part of a single-subject withdrawal design study. The class, therefore, served as its own control. Student on-task behavior was observed for 45 min following both inactive and active conditions using systematic direct observation procedures. The intervention consisted of 10 min of whole-body movement: 1–2 min of warm-ups, 6–8 min of moderate PA, and 1–2 min of cool-downs. Multiple measures of effect indicate that simple, 10-min, breaks for PA can improve TOT rates among elementary students. This study supports the use of brief breaks for PA to improve student TOT while also indicating that the effects persist for at least 45 min. This is valuable to educators who wish to increase TOT with a simple classroom intervention and for those who wish to help students meet the recommended amount of daily PA.     

Physical activity interventions in the school setting: A systematic review

Objectives

To review the effectiveness of school-based interventions with a physical activity component by measuring changes in psychological determinants, physical activity, and health outcomes.

Design

Systematic Review.

Method

We conducted a literature search of school-based controlled studies that involved a physical activity intervention targeting school students. Study design, methodological quality, and effectiveness of interventions on three target levels, ‘health and fitness’ (BMI and motor performance), ‘physical activity’, and ‘psychological determinants’ (knowledge of physical activity effects, self-concept, and attitudes towards physical activity), were analysed. Furthermore, we examined the influence of specific factors (e.g., age and gender) and mediator effects.

Results

The literature search identified 129 studies. The majority of the studies examining motor performance, physical activity, and knowledge of physical activity achieved significant results (69.7%, 56.8% and 87.5%, respectively). Significant effects on self-concept and attitudes were also found but to a smaller extent (in 30% and 43.8% of the studies, respectively). Only a few studies examining BMI (2.7%), physical activity (6.8%), and attitudes towards physical activity (12.5%) revealed negative effects, with better results observed for the control group. Intervention effects were influenced by the students’ age, intervention type, and frequency of the interventions. Self-efficacy was found to mediate the relationship between the program and the students’ physical activity.

Conclusions

Numerous school-based physical activity interventions achieved positive effects on three target levels. Further research is needed to clarify the mediator effects of psychological variables on physical activity and health and to increase our knowledge about the mechanisms that underlie behavioural change.     

The Impact of a Recess-Based Leadership Program on Urban Elementary School Students

The purpose of this study was to examine the impact of a peer-leadership training program on youth from a low-income urban school district. The methodological approach was grounded in community-based participatory research, in which a multicomponent school-based recess and physical activity program was examined. Data included 15 focus groups conducted with 77 fourth- and fifth-grade participants and semistructured interviews with 13 adult leaders. Results of a thematic content analysis suggest that decisions to join the program, role expectations, and training received impacted leadership development, personal development, and transfer of skills to other domains.     

Evaluating public posting,goal setting,and rewards to increase physical activity during school recess

We evaluated a pedometer‐based intervention consisting of public posting between two teams of students, with additional self‐monitoring, goal setting, and reinforcement components, to increase physical activity during school recess. In the absence of self‐monitoring, performance feedback alone did not increase physical activity levels above those observed during baseline. Additionally, higher levels of physical activity were observed when goal‐setting was introduced, with the highest levels of activity observed when raffle tickets could be earned for exceeding a specified step‐total goal.     

Family-based physical activity interventions and family functioning: A systematic review

Family physical activity (PA) can confer multiple health benefits, yet whether PA interventions affect general family functioning has not been appraised. The purpose of this review was to evaluate studies that have examined the effect of family PA interventions, where child PA was the focus of the intervention, on constructs of family functioning. Literature searches were concluded on January 11, 2022 using seven common databases. Eligible studies were in English, utilized a family PA intervention, and assessed a measure of family functioning as a study outcome. The initial search yielded 8413 hits, which was reduced to 20 independent PA interventions of mixed quality after screening for eligibility criteria. There was mixed evidence for whether family PA interventions affected overall family functioning; however, analyses of subdomains indicated that family cohesion is improved by PA interventions when children are in the early school years (aged 5–12). High-quality studies also showed an impact of family PA interventions on family organization. Targeted interventions at specific family subsystems (e.g., father–son, mother–daughter), characteristics (low-income, clinical populations, girls), and broad multibehavioral interventions may have the most reliable effects. Overall, the findings show that family PA interventions can promote family cohesion and organization, particularly among families with children in the early school years. Higher quality research, employing randomized trial designs and targeting specific intervention and sample characteristics (e.g., different clinical conditions, specific parent–child dyads), is recommended in order to better ascertain the effectiveness of these approaches.     

An Integrative Review of School-Based Mental Health Interventions for Elementary Students: Implications for Occupational Therapy

Occupational therapy for children and youth experiencing mental health conditions is often overlooked in current school-based services, as the traditional role within the system is often limited to physical health issues. The purpose of this integrative review is to investigate current psychosocial interventions within school settings to understand the effects of services provided and to determine potential roles for school-based occupational therapists. The findings of this review support occupational therapists in facilitating interventions that target mental health in school settings. Psychotherapy presented the strongest evidence for reducing psychosocial symptoms in school settings.     

Physical Activity and Physical Self-Concept among Sedentary Adolescent Females; An Intervention Study

PROBLEM: Physical activity has been promoted as a means of enhancing self-concept, yet the evidence for this connection is far from compelling. In particular, experimental research investigating this association during adolescence, a period during which many youth struggle to maintain a positive self-image, is noticeably lacking. This study investigates the impact on self-concept of a 9-month physical activity intervention among sedentary adolescent females. METHOD: Female adolescents who were sedentary at baseline were assigned either to an exercise intervention or a comparison group as part of the controlled trial. The intervention was school-based, and assignment to groups was based on school attended. Intervention participants engaged in supervised activity 4 times per week and received didactic instruction promoting activity outside of school 1 day per week. Self-concept, physical activity participation, and cardiovascular fitness were assessed before, mid-way through, and after the 9-month intervention. RESULTS: The intervention had a significant positive impact on participation in vigorous activity and cardiovascular fitness. The intervention did not significantly influence any of the self-concept dimensions overall. There was, however, a three-way interaction such that there was an increase in global physical self-concept among those intervention participants who increased cardiovascular fitness. CONCLUSIONS: These findings indicate that a physical activity intervention among sedentary adolescent females enhanced global physical self-concept for a subset of intervention participants who manifested positive changes in fitness.     

A randomized controlled trial of single versus multiple health behavior change: promoting physical activity and nutrition among adolescents.

Targeting multiple behaviors for change may provide significant health benefits. This study compared interventions targeting physical activity and nutrition (PAN) concurrently versus physical activity (PA) alone. Adolescents (N=138) were randomized to the PAN or PA intervention or control condition (n=46 per group). Primary outcomes were change in PA accelerometer and 3-day dietary recording from baseline to 3-month follow-up. The PAN and PA interventions were efficacious in supporting boys' (p<.001) but not girls' (p=.663) PA relative to the control condition. Dietary change was minimal. Although the findings do not reveal a decrement to PA promotion when a nutrition intervention was added, neither do they reveal any additional benefit. More studies comparing single versus multibehavioral interventions are needed.     

Memories of school recess predict physical activity enjoyment and social-emotional well-being in adults

School recess can provide social, emotional, and physical benefits for children. Yet, not all children experience recess the same, as inequity in access to recess and variability in the quality of recess exist. Researchers have yet to understand the long-term implications of recess experiences on adult well-being and physical activity behaviors. The purpose of this study was to explore the inter-relationships between memories of recess, physical activity, and social-emotional well-being. A total of 514 adults between the ages of 19 and 79 (M = 45.56; SD = 15.62) were surveyed via Prolific, a web-based research platform. Participants were asked about their memories of recess enjoyment and recess exclusion, and current physical activity levels, physical activity enjoyment, social isolation, social role satisfaction, and sense of meaning and purpose. Structural equation modeling analysis showed that memories of recess enjoyment were associated with meaning and purpose (β = 0.138, p < .05) and PA enjoyment (β = 0.183, p < .05). Furthermore, retrospective recess exclusion predicted current social isolation (β = 0.266, p < .05) and was negatively associated with retrospective recess enjoyment (β = −0.379, p < .05). Findings highlight the importance of childhood recess experiences and its impact on current physical activity behaviors, social isolation, and meaning and purpose later in life. Consistent with other research, early positive physical activity experiences, in the form of recess, appear to provide more assurances that one will engage in healthier lifestyle behaviors and more favorable psycho-socio-emotional profiles in adulthood.     

The Role of School-based Group Mentoring in Promoting Resilience among Vulnerable High School Students

This study examined the role of participation in a year-long school-based group mentoring program, Project Arrive (PA), on increasing resilience during the first year of high school among students identified as being at high risk for school dropout. Participants were 114, ninth grade students taking part in one of 32 PA mentoring groups, and 71 statistically matched comparison students (53% male, 75% eligible for free/reduced-price lunch, 62% Latinx). Using a propensity score with inverse probability of treatment weighting (IPTW) to reduce selection bias, and a multi-level model to account for non-independence of data within mentoring groups, we examined changes from pre-test to program exit on seven external resilience resources (developmental supports and opportunities) and four internal resilience assets (personal strengths). At program exit, PA participants had higher adjusted means than comparisons on six external resources, including school support, school belonging, school meaningful participation, peer caring relationships, prosocial peers, and home meaningful participation. PA participants also had higher adjusted means on one internal asset, problem solving. Results point to the promise of group mentoring as an approach for increasing resilience among academically vulnerable adolescents.     

Promoting School Students’ Physical Activity: A Social Ecological Perspective

Guided by a social ecological perspective, the aim of this study was to investigate the predictive strength of individual (barrier self-efficacy), social environmental (support from parents, friends, physical education teachers), and physical environmental variables (equipment accessibility, neighborhood safety) toward physical activity among school students. Participants were 285 students enrolled in a suburban public school. Hierarchical linear regression analysis highlighted the influence of self-efficacy, social support from parents, friends, physical education teachers, and accessible equipment on students’ physical activity. The findings indicated that physical educators and health promoters need to consider multiple factors as they design effective interventions to promote physical activity and prevent physical inactivity among school students. This study also supported the use of a social ecological perspective to investigate students’ physical activity.     

The effect of school-based kindergarten transition policies and practices on child academic outcomes

This study examined the effect of school-based kindergarten transition policies and practices on child outcomes. The authors followed 17,212 children from 992 schools in the Early Childhood Longitudinal Study-Kindergarten sample (ECLS-K) across the kindergarten school year. Hierarchical linear modeling revealed that the number of school-based transition practices in the fall of kindergarten was associated with more positive academic achievement scores at the end of kindergarten, even controlling for family socioeconomic status (SES) and other demographic factors. This effect was stronger for low- and middle-SES children than high-SES children. For low-SES children, 7 transition practices were associated with a .21 standard deviation increase in predicted achievement scores beyond 0 practices. The effect of transition practices was partially mediated by an intervening effect on parent-initiated involvement in school during the kindergarten year. The findings support education policies to target kindergarten transition efforts to increase parent involvement in low-SES families.     

Mediators of behavior change in two tailored physical activity interventions for adolescent girls

ObjectivesIt has been suggested that the lack of knowledge regarding the mechanisms responsible for behavior change may be responsible for the low levels of effectiveness in physical activity interventions among youth. While it is common for physical activity interventions to cite a theoretical framework, few test the validity of their constructs using an established mediation analysis technique. The purpose of this study was to identify mediators of physical activity behavior change in two tailored interventions for adolescent girls.DesignThis study involved an experimental design.MethodsParticipants (N=161) were randomly allocated to a control (CON) group, an intervention based on the Health Promotion (HP) Model or an intervention developed from the HP Model that included two processes from the Transtheoretical Model (THP). Both interventions included school-based education sessions, individual counseling sessions, and two physical activity sessions completed with the participants' mothers. Measures were assessed prior to the intervention, at post-intervention and at a 6-month follow-up. The following constructs were included in the mediation analyses: perceived benefits, perceived barriers, self-efficacy, exposure to models, social support, interpersonal norms, planning, stimulus control, and counterconditioning.ResultsPerceived benefits, perceived barriers, self-efficacy, and commitment to planning satisfied the criteria for mediation in the THP intervention. Self-efficacy and commitment to planning were identified as mediators in the HP intervention.ConclusionThe results of this study provide evidence that both interventions were successful in increasing physical activity through changes in the theoretical constructs.     

Urban Latino school children's physical activity correlates and daily physical activity participation: a social cognitive approach

Guided by Social Cognitive Theory (Bandura, 1986), this study investigated the relationships between urban Latino children's physical activity (PA) correlates and their daily PA levels. The participants were 120 Latino children recruited from an urban elementary school. They completed questionnaires assessing their PA correlates (self-efficacy, outcome expectancy, social support, and physical and social environmental factor) and their one-week PA levels were measured by accelerometers. Correlation and multiple regression analyses were performed to examine the relationships between children's PA correlates and daily PA levels. Correlation analyses indicated that children's self-efficacy, social support, and physical and social environmental factor were positively related to their PA levels. Regression analyses further yielded that children's self-efficacy and social support emerged as significant contributors of their daily PA levels. However, outcome expectancy and physical and social environmental factor failed to predict PA levels. The findings were discussed in regard to the implications for practice and areas for future research.     

The Link: An Alternative Educational Program in the Netherlands to Reengage School-Refusing Adolescents With Schooling

Facets of school life affect the development and maintenance of school refusal (SR). These facets will warrant attention during intervention for SR. This paper considers a range of school-related factors associated with SR, grouped according to five domains of school climate. It also describes school-based interventions for SR in the form of alternative educational programs (AEPs). The paper then presents the Link, an AEP for Dutch adolescents with SR. The Link offers an educational setting that addresses school-related factors associated with SR. After participation in the Link, adolescents are helped to return to a more typical educational setting. Based on a review of 30 case files, we provide an account of adolescents who have participated in the Link. Often, these adolescents displayed chronic and severe SR, met criteria for anxiety or depressive disorders, and were diagnosed with an autism spectrum disorder. The Link process is illustrated via a case vignette. Thereafter, the role of AEPs in the treatment of SR is discussed.     

Motivation for Physical Activity among Hawaiian,Japanese, and Filipino University Students in Hawaii

The purpose is to identify the motivations and barriers to physical activity (PA) among the three largest ethnic groups in Hawaii (Hawaiians/part-Hawaiians, Japanese, and Filipinos). University of Hawai'i students (N = 32, aged 18+) self-identified as one of those ethnicities participated in focus groups. There are more common themes than ethnic-specific variations in factors influencing PA. PA is understood as exercise among all groups; leisure time PA like running and surfing are common activities. Results were more similar among Hawaiian and Japanese than with Filipino participants. The findings offer an opportunity for improving cross-cultural and culture-specific PA interventions for those ethnicities.     

Physical activity status of academic professors during their early career transition: an application of the theory of planned behavior

Life-transitions (e.g. parenthood) have been linked to physical inactivity, yet the topic requires further exploration. In this study, we evaluated changes in the physical activity (PA) of adults during their early career transition using retrospective analysis and the theory of planned behavior. Recruitment from January to March 2010 yielded a random sample of 267 assistant professors, ages 25-44, employed within the last five years. Repeated measures analysis of variance (RM ANOVA) concluded that PA declined across the transition (d?=?0.36-0.43) and was further attenuated by marriage, work hours, and parenthood status. Discriminant function analysis (DFA) identified specific behavioral and control correlates about PA enjoyment, limited time, inconsistent schedule, work demands, and job pressures to distinguish between those who remained active from those who did not across the transition. PA interventions administered prior to career transitions may be needed to prevent physical inactivity.     

Implementing Family-Centered Interventions Within the Public Middle School: Linking Service Delivery to Change in Student Problem Behavior

The Adolescent Transitions Program is a family-centered intervention strategy designed to reduce problem behavior and prevent drug use within a public school environment. A parent consultant within a Family Resource Center (FRC) provided universal, selected, and indicated interventions that enhanced and supported positive parenting practices known to serve as protective factors. Implementation of the 3-year FRC model involved 584 students and their families in 4 middle schools. Analyses focused on the dynamics and effects of parent consultant activities and services. Differences in school “adoption” of the FRC services were found to be a function of both passage of time and school environment. Despite significant variation in implementation across schools, FRC services significantly reduced the growth in problem behavior over the course of the middle-school years. The implications of these findings for dissemination of empirically supported, school-based, family-centered interventions are discussed.     

The Cooperative Research Centre for Living with Autism (Autism CRC) Conceptual Model to Promote Mental Health for Adolescents with ASD

Despite an increased risk of mental health problems in adolescents with autism spectrum disorder (ASD), there is limited research on effective prevention approaches for this population. Funded by the Cooperative Research Centre for Living with Autism, a theoretically and empirically supported school-based preventative model has been developed to alter the negative trajectory and promote wellbeing and positive mental health in adolescents with ASD. This conceptual paper provides the rationale, theoretical, empirical and methodological framework of a multilayered intervention targeting the school, parents and adolescents on the spectrum. Two important interrelated protective factors have been identified in community adolescent samples, namely the sense of belonging (connectedness) to school and the capacity for self and affect regulation in the face of stress (i.e. resilience). We describe how a confluence of theories from social psychology, developmental psychology and family systems theory, along with empirical evidence (including emerging neurobiological evidence), supports the interrelationships between these protective factors and many indices of wellbeing. However, the characteristics of ASD (including social and communication difficulties, and frequently difficulties with changes and transitions, and diminished optimism and self-esteem) impair access to these vital protective factors. The paper describes how evidence-based interventions at the school level for promoting inclusive schools (using the Index for Inclusion) and interventions for adolescents and parents to promote resilience and belonging [using the Resourceful Adolescent Program (RAP)] are adapted and integrated for adolescents with ASD. This multisite proof-of-concept study will confirm whether this multilevel school-based intervention is promising, feasible and sustainable.