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The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis
Open accessAbstract
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.
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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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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Heterogeneity analysis indicated significant between-study variance (Q= 80.12, p<0.001;I 2 = 94.91%).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.10 Meta-analysis
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Significant effects were observed for studies with * or ** bias ratings (k= 13, g = 0.09, p<.05), for multi-component interventions (k= 7, g = 0.09, p<.05), and for interventions underpinned by theory (k= 12, g = 0.07, p<.05) but the magnitudes of these were small (Table 4).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.10 Meta-analysis
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although heterogeneity from the pooled analysis was low, the individual effects from the included studies were extremely inconsistent, ranging from g= -0.29 to 1.04.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.10 Meta-analysis
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“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=.05).”
- Also stated in: § 3.10 Meta-analysis · hedged
“Once this study was removed the average treatment effect was significantly reduced by 0.30, indicating a very small positive effect which approached significance (k = 16, g= 0.07, p=.05) (Figure 2).”
- Also stated in: § 4. Discussion · hedged
“The meta-analysis results indicate that school-based PA interventions have only a very small effect on adolescent girls' PA levels.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § 3.10 Meta-analysis · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twenty studies were identified as meeting the inclusion criteria and were included in a narrative synthesis.”
- Also stated in: § 3.1 Literature Search · plain
“After screening and eligibility assessments, 20 records met the inclusion criteria for the narrative synthesis (Figure 1).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § 3.1 Literature Search · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“interventions underpinned by theory (k= 12, g = 0.07, p<.05)”
- Also stated in: § 3.10 Meta-analysis · plain
“Significant effects were observed for studies with * or ** bias ratings (k= 13, g = 0.09, p<.05), for multi-component interventions (k= 7, g = 0.09, p<.05), and for interventions underpinned by theory (k= 12, g = 0.07, p<.05) but the magnitudes of these were small (Table 4).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § 3.10 Meta-analysis · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Inspection of the funnel plot for publication bias indicated asymmetry.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.10 Meta-analysis
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Egger's regression test was significant (z = 2.07, p<.05).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.10 Meta-analysis
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fifteen studies provided outcome data with <20% dropout/withdrawal rates.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.7 Behaviour Change Theories
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analysis revealed very small significant effects for multi-component interventions (k= 7, g= 0.09, p<.05)”
- Also stated in: § 3.10 Meta-analysis · plain
“Significant effects were observed for studies with * or ** bias ratings (k= 13, g = 0.09, p<.05), for multi-component interventions (k= 7, g = 0.09, p<.05), and for interventions underpinned by theory (k= 12, g = 0.07, p<.05) but the magnitudes of these were small (Table 4).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § 3.10 Meta-analysis · plain
- It may state two separate claims as one. 14
- Probably not a substantial claim. 11
- The quote only partly states this claim. 2
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although eleven studies stated a randomisation procedure, the majority (n=10) did not provide an explicit explanation of the randomisation process”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.7 Behaviour Change Theories
Strength:plain· not yet calibratedn = 10Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirteen studies employed objective measures of PA, either for the complete sample size or for a sub-sample.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.7 Behaviour Change Theories
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analyses also revealed no effect for whether the interventions were targeted at girls only or mixed-sex, although only 3 mixed sex studies were included.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.10 Meta-analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All studies scored weakly for allocation of concealment and/or blinding, with just two studies attempting to blind intervention staff (Jago et al., 2012;Webber et al., 2008).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.7 Behaviour Change Theories
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The trim and fill procedure added 3 studies to the left side of the plot which reduced the overall treatment effect by 0.01.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.10 Meta-analysis
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was a significant small positive treatment effect for schoolbased PA interventions for adolescent girls (k=17, g= 0.37, p<.05).”
- Also stated in: § 3.10 Meta-analysis · plain
“The meta-analysis revealed a significant small positive treatment effect (k=17, g= 0.37, p<.05,)”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
- Also stated in: § 3.10 Meta-analysis · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Few studies reported theoretical fidelity, which precludes direct inferences being made between intervention effectiveness and underpinning theory.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“As found in previous reviews, both for PA interventions for adolescents (Camacho-Minano et al., 2011) and schoolbased behavioural interventions (Khambalia, Dickinson, Hardy, Gill, & Baur, 2012), allocation concealment and blinding were usually absent, and this negatively affected the risk of bias scores for the majority of included studies.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
What the sources say
- Not checked yetcites Camacho-Minano et al., 2011 source
- Not checked yetcites Khambalia, Dickinson, Hardy, Gill, & Baur, 2012
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“Risk of bias scores were low across the included interventions mainly due to the need for a greater explanation of the randomisation process which is consistent with a previous systematic review of adolescent girls (Camacho-Minano et al., 2011).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
What the sources say
- Not checked yetcites Camacho-Minano et al., 2011 source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only one study received a 'very strong' risk of bias score (Jago et al., 2012); three studies received a 'strong' risk of bias score (Fairclough & Stratton, 2005;Jago et al., 2015;Webber et al., 2008); ten studies received a 'moderate' risk of bias score”
- Also stated in: § 3.7 Behaviour Change Theories · plain
“six studies received a 'weak' risk of bias score (Bronikowski & Bronikowska, 2011;Haerens et al., 2006;Pate et al., 2005;Schofield et al., 2005;Spruijt-Metz et al., 2008;Young et al., 2006).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 3.7 Behaviour Change Theories
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
- Also stated in: § 3.7 Behaviour Change Theories · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Multicomponent interventions and interventions underpinned by theory may be the most effective approaches to positively change adolescent girls' PA.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“It was reported that a lack of convincing evidence exists that interventions underpinned by theory were more effective than those with no specified theory (Mears & Jago, 2016).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
What the sources say
- Not checked yetcites Mears & Jago, 2016
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This systematic review was registered with PROSPERO (Registration number: CRD42016037428)”
- Also stated in: § 1. Methods · plain
“This systematic review was registered with PROSPERO (Registration number: CRD42016037428).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § 1. Methods · plain
In the paper
“This is consistent with findings from a recent review investigating the effectiveness of after-school PA interventions to increase MVPA (Mears & Jago, 2016).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
What the sources say
- Not checked yetcites Mears & Jago, 2016
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesThe quote only partly states this claim.
In the paper
“PRISMA guidelines (2009) were followed throughout.”
- Also stated in: § 1. Methods · plain
“This review adhered to the PRISMA reporting guidelines for systematic reviews (Moher, Liberati, Tetzlaff, & Altman, 2009).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Abstract
What the sources say
- Not checked yetcites Moher, Liberati, Tetzlaff, & Altman, 2009 source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § 1. Methods · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These difficulties may in part be due to a number of factors such as, social or cultural norms, ability to provide a wide range of PA opportunities, short-term intervention periods, PA measurement methods, and small sample sizes which precluded the detection of significance.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Initially, the first author (MO) screened all titles and abstracts for obvious irrelevance, and a random sample (20%) were also checked by another author (WC).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 2.2 Inclusion and Exclusion Criteria
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The inclusion of all study types, including feasibility and pilot studies, may have impacted the overall findings of the review as these tended to be smaller scale projects with small sample sizes.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4.1 Strengths and Limitations
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Multicomponent intervention designs are consistent with the concept of Comprehensive School PA Programmes (CSPAPs), which are recommended as effective strategies to increase young people's PA (Centers for Disease Control and Prevention, 2013;World Health Organisation, 2010).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
What the sources say
- Not checked yetcites Centers for Disease Control and Prevention, 2013
- Not checked yetcites World Health Organisation, 2010
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The full-text of eligible studies were then retrieved and reviewed by two authors (MO and WC).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 2.2 Inclusion and Exclusion Criteria
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Relevant data from the selected studies were extracted by the first author (MO) and checked by the second author (WC) (see Table 1).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 2.3 Data Extraction and Synthesis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Camacho-Minano et al. (2011) and Pearson et al. (2015) suggested that school-based PA interventions are the most promising setting to impact adolescent girls' PA levels.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > Introduction
What the sources say
Load-bearingStrength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Similarly, Camacho-Minano et al. (2011) suggested that school-based interventions are more effective when enjoyment of PE is prioritised and girls are given freedom of choice of activities.”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
What the sources say
- Not checked yetcites Camacho-Minano et al., 2011 source
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“This could be due to the structure a school environment provides and the influence schools have on girls of this age (Kohl & Cook, 2013).”
§ The Effectiveness of School-Based Physical Activity Interventions for Adolescent Girls: A Systematic Review and Meta-analysis > 4. Discussion
What the sources say
- Not checked yetcites Kohl & Cook, 2013
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
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.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“the theory of expanded, extended, and enhanced opportunities (TEO), which proposes a common taxonomy to identify appropriate targets for interventions across different settings and contexts, could afford a more practical approach to school-based PA interventions.19, 37”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [19]
In the citing paper
“the theory of expanded, extended, and enhanced opportunities (TEO), which proposes a common taxonomy to identify appropriate targets for interventions across different settings and contexts, could afford a more practical approach to school-based PA interventions.19, 37”
From A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children (2020) · cites this paper as [19]
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”
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
MinorThe sentence says three interventions were after-school dance interventions but names only two studies.
“three were after-school dance interventions (Jago et al., 2015;Jago et al., 2012)”
“Two were delivered by dance instructors (Jago et al., 2015;Jago et al., 2012), who taught dance-specific sessions.”
Risk-of-bias ratings for the two Jago studies are reversed
MinorThe 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.
“Only one study received a 'very strong' risk of bias score (Jago et al., 2012); three studies received a 'strong' risk of bias score (Fairclough & Stratton, 2005;Jago et al., 2015;Webber et al., 2008)”
“| 8. | Jago et al. | X | | X | X | *** | | | 2012 | | | | | | | 9. | Jago et al. | X | X | X | X | **** | | | 2015 | | | | | |”
Citations
Cites
Statistical Power Analysis for the Behavioral Sciences
Muller, K. E., & Cohen, J. (1989) · Technometrics · doi:10.2307/1270020 · Cited by 99,603
Statistical power analysis for the behavioral sciences
Cohen, J. (1990) · Computers Environment and Urban Systems · doi:10.1016/0198-9715(90)90050-4 · Cited by 65,417
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
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Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
Conducting Meta-Analyses in R with the metafor Package
Viechtbauer, W. (2010) · Journal of Statistical Software · doi:10.18637/jss.v036.i03 · Cited by 20,464
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A basic introduction to fixed-effect and random-effects models for meta-analysis
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2010) · Research Synthesis Methods · doi:10.1002/jrsm.12 · Cited by 6,793
Flagged first, then by citations
4 of the 72 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- Higgins, 2011, Vol. 4
- 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
Cited by
Sorted by citations
Items 201–264 of 264
Suicide rate among the 15-19 year-olds, 3-year average, 2015-17 (or nearest years)
(2020) · Health at a glance. Europe · doi:10.1787/ff359171-en
Limitations in daily activities among people aged 65 and over, by gender, 2017
(2020) · Health at a glance. Europe · doi:10.1787/bc171129-en
Total fertility rate, number of children per women aged 15-49, 1960 to 2018, or nearest year
(2020) · Health at a glance. Europe · doi:10.1787/49f4c9a1-en
Trends in life expectancy, 2005-18
(2020) · Health at a glance. Europe · doi:10.1787/ca628d6b-en
Hospital expenditure by type of service, 2018
(2020) · Health at a glance. Europe · doi:10.1787/2d88b229-en
Vaccination against influenza, people aged 65 and over, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/9ef61f61-en
Out-of-pocket spending on health, by type of services, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/44c650eb-en
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/f72f7beb-lt
Trends in repeated drunkenness among the 15-year-olds, EU average, 1993 to 2018
(2020) · Health at a glance. Europe · doi:10.1787/8ba66f68-en
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/25853fff-el
Life expectancy and healthy life years at birth, by gender, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/40659cee-en
Reasons for not getting vaccinated among people aged 65 and over, 2019
(2020) · Health at a glance. Europe · doi:10.1787/af797e42-en
Extent of health care coverage
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/37321608-en
Out-of-pocket spending on health as share of final household consumption, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/2d31dfa3-en
Overweight and obesity rate among 15-year-olds, 2018 and trends since 2010
(2020) · Health at a glance. Europe · doi:10.1787/a0b62e03-en
Health expenditure as a share of GDP, 2019 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/4c4192ca-en
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/eea3cf94-nl
Mortality rates from avoidable causes, 2017
(2020) · Health at a glance. Europe · doi:10.1787/75cc7785-en
Overall volume of antibiotics prescribed in primary care, 2017 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/fe9a381b-en
Variation across hospitals in 30-day mortality after admission for AMI, 2015-17
(2020) · Health at a glance. Europe · doi:10.1787/df258d60-en
(2020) · Health at a glance. Europe · doi:10.1787/0d42a0f9-en
Changes in gross fixed capital formation, in real terms, selected countries, 2005-18
(2020) · Health at a glance. Europe · doi:10.1787/e9a74d07-en
People with diabetes in EU27, by gender and age group, 2019
(2020) · Health at a glance. Europe · doi:10.1787/76447e13-en
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/dcc1f4bd-es
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/85ef89b8-en
Cannabis use over last 12 months among people aged 15 to 34, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/8cc71f9a-en
Notification rate of measles, 2019
(2020) · Health at a glance. Europe · doi:10.1787/090e4b75-en
Chronic diseases and disabilities among older people
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/f44c34f1-en
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/531bce87-fi
(2020) · Health at a glance. Europe · doi:10.1787/f15e2516-en
Benzodiazepine use in people aged 65 and over, 2017 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/64fbe551-en
Hospital discharges per 1 000 population, 2000 and 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/7fa20104-en
(2020) · Health at a glance. Europe · doi:10.1787/6b5714dd-en
Private health insurance coverage, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/4f7f9566-en
(2020) · Health at a glance. Europe · doi:10.1787/8da8c9ac-en
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/58a359ac-en
(2020) · Health at a glance. Europe · doi:10.1787/7251bbf2-en
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/6f2bd3dd-sv
Life expectancy and healthy life years at 65, by gender, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/dac6daf2-en
Average length of stay for normal delivery, 2018 (or nearest year)
(2020) · Health at a glance. Europe · doi:10.1787/c82764d4-en
(2022) · Journal of Health Sports and Kinesiology · doi:10.47544/johsk.2022.11.30
An examination of nutrition, exercise, and attitudes towards sport in female university students
İMAMOĞLU, M. (2023) · Revista de Investigaciones Universidad del Quindío · doi:10.33975/riuq.vol35n1.831
FITeens Toolkit. Promoting health-related behaviours in the educational context
García‐González, L., Abós, Á., & Sanz-Remacha, M. (2023) · Universidad de Zaragoza eBooks · doi:10.26754/uz.978-84-18321-83-2 · Cited by 1
McCarthy, N., Hall, A. E., Nathan, N., Sutherland, R., Campbell, L., Shoesmith, A., Gibson, E. R., Gardner, C., Neil‐Sztramko, S., & Hodder, R. K. (2023) · Research Square · doi:10.21203/rs.3.rs-3198161/v1 · Cited by 1
FITeens Toolkit. Tervisega seotud käitumiste edendamine hariduslikus kontekstis
García‐González, L., Abós, Á., Sanz-Remacha, M., Burgueño-Mengíbar, R., Diloy-Peña, S., Mayo-Rota, C., García-Cazorla, J., Sevil‐Serrano, J., Pérez-Ovejero, D., Testillano, I. Á., et al. (2023) · Universidad de Zaragoza eBooks · doi:10.26754/uz.978-84-18321-95-5 · Cited by 1
FITeens Toolkit. Terveyteen liittyvien käyttäytymismallien edistäminen opetuksessa
García‐González, L., Abós, Á., Sanz-Remacha, M., Burgueño-Mengíbar, R., Diloy-Peña, S., Mayo-Rota, C., García-Cazorla, J., Sevil‐Serrano, J., Pérez-Ovejero, D., Testillano, I. Á., et al. (2023) · Universidad de Zaragoza eBooks · doi:10.26754/uz.978-84-18321-94-8
Waiting times for hip fracture surgery
(2020) · Health at a glance. Europe · doi:10.1787/4315b545-en
Fiteens toolkit. Bevordering van gezondheidsgeraleerd gedrad in de orderwijscontext
García‐González, L., Abós, Á., & Sanz-Remacha, M. (2023) · Universidad de Zaragoza eBooks · doi:10.26754/uz.978-84-10169-03-6
Fiteens tookit promoçao de comportamentos relacionados com a saúde em contexto educacional
García‐González, L., Abós, Á., & Sanz-Remacha, M. (2023) · Universidad de Zaragoza eBooks · doi:10.26754/uz.978-84-10169-04-3
FITeens Toolkit. Promoción de comportamientos relacionados con la salud en el contexto educativo
García‐González, L., Abós, Á., & Sanz-Remacha, M. (2023) · Universidad de Zaragoza eBooks · doi:10.26754/uz.978-84-10169-02-9
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/818d288b-pl
OECD, & Union, E. (2020) · Health at a glance. Europe · doi:10.1787/cab3ab19-de
(2020) · Health at a glance. Europe · doi:10.1787/da5bba97-en
Tobacco and cannabis smoking among children and adolescents
(2020) · Health at a glance. Europe · doi:10.1787/77bdc401-en
Lee, T. K., Zhu, J., Kim, Y., Jiang, Z.-K., Zhang, M., Choi, W., Pak, T.-Y., & Song, H. (2024) · Journal of Preventive Medicine and Public Health · doi:10.3961/jpmph.24.236
Davis, A., Gross, S., McEntyre, K., Biber, D., & Meyer, A. M. (2025) · Women in Sport and Physical Activity Journal · doi:10.1123/wspaj.2025-0030
Beregi, E., & Bognár, J. (2025) · Magyar Pedagógia · doi:10.14232/mped.2025.3.205
Morgan, P. J., Grounds, J. A., O’Connor, R., Lee, D. R., & Ashton, L. (2026) · BMC Public Health · doi:10.1186/s12889-026-26287-7
“However, long-term follow up, particularly beyond 12 months, is severely lacking in interventions targeting: children’s physical activity in families [19, 21], wellbeing [22, 23], fathering [24], men’s health [25, 26], and girls’ physical activity [27, 28].”
Cox, A. E., Ullrich-French, S. C., McMahon, A. K., Estelle, C., Ulofoshio, A., & Nourollahimoghadam, M. (2026) · Health Promotion Practice · doi:10.1177/15248399261429433
Frömel, K., Groffik, D., Mitáš, J., Kudláček, M., & Pratt, M. (2026) · Research Square · doi:10.21203/rs.3.rs-9423876/v1
Domaradzki, J., & Koźlenia, D. (2026) · Human Movement · doi:10.5114/hm/221248
“Similar conclusions have been reported in recent school-based trials showing that structured physical activity programs can yield comparable benefits across socioeconomic groups when delivered universally within the school curriculum [36, 37].”
Celik, S., Gracia, P., Gonzalez-Vila, P., & Tarantino, G. (2026) · Adolescent Research Review · doi:10.1007/s40894-026-00287-5 · Cited by 2
“…school-based interventions can effec - tively improve sedentary behaviors and active lifestyles (Demetriou & Höner, 2012; Kriemler et al., 2011; Owen et al., 2017 ), healthy eating habits (Medeiros et al., 2022; Van Cauwenberghe et al., 2010), and mental health outcomes (Cilar et al., 2020;…”
Small, C., Walters, G. W. M., Fountain, S. M., Dring, K. J., Bowes, A., Cooper, S., & Williams, R. (2026) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2026.2720480
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.
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 105
- Pages
- 237-249
- ISSN
- 0091-7435 (ISSN-L)
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-08, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-08 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
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