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Cited by 280Physical Activity and HealthObesity, Physical Activity, DietSchool Health and Nursing Education

The DOI matches its Crossref record; 68 of the 72 references it cites were found in a registry or an index; none of the 28 sources its claims cite is checked for support yet.

The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis

Open access
Owen, Michael B., Curry, Whitney B., Kerner, Charlotte, Newson, Lisa, Fairclough, Stuart J.·2017·Preventive Medicine
DOI 10.1016/j.ypmed.2017.09.018
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Abstract

Physical activity (PA) decreases during the transition from childhood to adolescence, with larger declines observed in girls. School-based interventions are considered the most promising approach for increasing adolescents' PA levels although, it is unclear which types of school-based interventions have the greatest impact. The objective of this systematic review is to assess the impact and design of school-based PA interventions targeting adolescent girls. A systematic search was conducted using four electronic databases (PubMed, Web of Science, SPORTDiscus and PsychInfo). This systematic review was registered with PROSPERO (Registration number: CRD42016037428) and PRISMA guidelines (2009) were followed throughout. Twenty studies were identified as meeting the inclusion criteria and were included in a narrative synthesis. Seventeen studies were eligible for inclusion in a meta-analysis. There was a significant small positive treatment effect for school-based PA interventions for adolescent girls (k=17, g=0.37, p<0.05). After an outlier was removed (residual z=7.61) the average treatment effect was significantly reduced, indicating a very small positive effect (k=16, g=0.07, p=0.05). Subgroup analysis revealed very small significant effects for multi-component interventions (k=7, g=0.09, p<0.05), interventions underpinned by theory (k=12, g=0.07, p<0.05), and studies with a higher risk of bias (k=13, g=0.09, p<0.05). Intervention effects were very small which indicates that changing PA behaviors in adolescent girls through school-based interventions is challenging. Multi-component interventions and interventions underpinned by theory may be the most effective approaches to positively change adolescent girls' PA.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis found that school-based physical activity interventions for adolescent girls had only a very small positive effect after removing an outlier. Multi-component interventions and interventions underpinned by theory showed small significant effects, but changing adolescent girls’ physical activity through school-based programmes remains challenging.

Key findings

  • Across 17 studies, school-based physical activity interventions showed a significant small positive treatment effect for adolescent girls (k=17, g=0.37, p<.05). After removing one outlier (Taymoori et al., 2008; residual z=7.61), the effect fell to a very small positive effect (k=16, g=0.07, p=.05).
  • Subgroup analyses found very small significant effects for multi-component interventions (k=7, g=0.09, p<.05), interventions underpinned by theory (k=12, g=0.07, p<.05), and studies with higher risk of bias (k=13, g=0.09, p<.05).
  • Heterogeneity was high in the main analysis (Q=80.12, p<0.001; I²=94.91%) and substantially reduced after outlier removal (Q=23.98, p=0.05; I²=0.01%). Publication bias was indicated: trim-and-fill added 3 studies and reduced the overall effect by 0.01; Orwin’s fail-safe N was 16; Egger’s regression test was significant (z=2.07, p<.05).
  • The review included 20 studies in narrative synthesis, evaluating 10,755 girls (mean age=12.88 years); 17 studies were eligible for meta-analysis.

Methods

  • Systematic review and meta-analysis registered with PROSPERO (CRD42016037428) and reported using PRISMA. Four databases were searched: PubMed, Web of Science, SPORTDiscus, and PsychInfo; journal articles published in English after 31/12/2004 up to 01/12/2016 were considered.
  • Inclusion criteria covered school-based physical activity interventions among adolescent girls (mean age 11–18 years), with objectively measured or self-reported physical activity outcomes; mixed-sex studies were included if girls’ data were reported separately or provided on request. Twenty studies met criteria for narrative synthesis, and 17 had sufficient data for meta-analysis.
  • Meta-analysis used R with the metafor package, random-effects models, and Hedges’ g. Heterogeneity was assessed with Cochrane’s Q and I²; subgroup analyses examined measurement method, intervention duration, risk of bias, intervention design, underpinning theory, and target sex. Outliers and publication bias were assessed using residual values, funnel plots, trim-and-fill, Orwin’s fail-safe N, and Egger’s regression test.

Limitations

  • The paper states that 21 studies were excluded because authors did not respond to requests for physical activity data by gender within a 7-day timescale; this limited response time could have doubled the number of included studies, and interaction by sex tests were not explored for those studies.
  • The paper states that including all study types, including feasibility and pilot studies, may have affected overall findings because these tended to be smaller-scale projects with small sample sizes. It also notes that where multiple primary physical activity outcomes were reported, MVPA or MPA was used where possible, but alternative outcomes such as steps and accelerometer counts were sometimes included.
  • The paper reports that all studies scored weakly for allocation concealment and/or blinding, only two studies attempted to blind intervention staff, and most studies did not explicitly explain randomisation. Evident from the text: the main pooled estimate had very high heterogeneity before outlier removal, publication bias was judged highly probable, and only 3 mixed-sex studies were available for the target-sex subgroup analysis.

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Integrity signals

Registry

Crossref · 10.1016/j.ypmed.2017.09.018

Cites

68 of 68 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

0 of 28 cited sources checked · 0 supported · 0 flagged

Show all 37 claims

  • It may state two separate claims as one. 14
  • Probably not a substantial claim. 11
  • The quote only partly states this claim. 2
24 of 24

  • The paper relies on this without support.

    Mixed-sex interventions may be as effective for girls as girls-only interventions.

    “when mixed-sex interventions could be equally as effective for girls.”

  • The paper relies on this without support.

    Physical education occurs infrequently within schools, usually 1-2 hours per week, and accounts for only a very small percentage of weekly waking hours.

    “However, PE occurs infrequently within schools (usually 1-2 hours per week) and accounts for only a very small percentage of weekly waking hours, therefore its impact on total daily MVPA is limited.”
2 of 2

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Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentz = 2.07reported p < .05 · recomputed p = .038

    “(z = 2.07, p < .05”

1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • After-school dance count does not match its list

    Minor

    The sentence says three interventions were after-school dance interventions but names only two studies.

  • Risk-of-bias ratings for the two Jago studies are reversed

    Minor

    The text identifies Jago et al. (2012) as the only very-strong-rated study and Jago et al. (2015) as strong. Table 3 assigns them *** and ****, respectively-the reverse.

2 of 2

Citations

Cites

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Show all 72 references

4 of the 72 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Higgins, 2011, Vol. 4
  2. Martin, 2008, Dance as a health enhancing physical activity: an extra-curricular teaching intervention to increase physical activity in girls dance, Physical Education Matters, 3, 37

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Metadata

Authors
Owen, M. B., Curry, W. B., Kerner, C., Newson, L., & Fairclough, S. J.
Affiliations
  • Edge Hill University (GB)
  • Brunel University of London (GB)
  • Liverpool John Moores University (GB)
Corresponding author
Owen, Michael B.
ORCID
Venue
Preventive Medicine
Publisher
Elsevier BV
Published
2017-12
Volume
105
Pages
237-249
ISSN
0091-7435 (ISSN-L)
DOI
10.1016/j.ypmed.2017.09.018
OpenAlex
W2759514624
Semantic Scholar
f5cac54bc86ac5fadc6ebf0610b7770bd78ce25a
Cited by
280
References
72
Citations by year
2026: 9 · 2025: 10 · 2024: 23 · 2023: 21 · 2022: 32 · 2021: 26 · 2020: 131 · 2019: 20 · 2018: 8
FWCI
5.33
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Liverpool John Moores University (acceptedVersion)
  • Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
  • Brunel University Research Archive (BURA) (Brunel University London) (submittedVersion)
  • Figshare (submittedVersion, cc-by-nc-sa)
  • Edge Hill University Research Information Repository (Edge Hill University) (submittedVersion, cc-by-nc-nd)
  • Edge Hill University (submittedVersion)
  • University of Limerick Institutional Repository (University of Limerick) (submittedVersion, cc-by-nc-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › School Health and Nursing Education
Keywords
school-based intervention, physical activity, adolescent girls, physical activity promotion, multicomponent intervention, theory-based intervention, intervention effectiveness, risk of bias, transition to adolescence
MeSH terms
Adolescent, Adolescent Behavior, Health Promotion, Humans, Schools, Health Behavior, Exercise

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