Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update
Open accessAbstract
Background: School-based interventions are thought to be the most universally applicable and effective way to counteract low physical activity (PA) and fitness although there is controversy about the optimal strategy to intervene. Objectives The objective of this review was to summarise recent reviews that aimed to increase PA or fitness in youth and carry out a systematic review of new intervention studies. Methods: Relevant systematic reviews and original controlled and randomised controlled school-based trials with a PA or fitness outcome measure, a duration of ≥12 weeks, a sufficient quality and involvement of a healthy population aged 6–18 years that were published from 2007 to 2010 were included. Results: In these reviews, 47–65% of trials were found to be effective. The effect was mostly seen in school-related PA while effects outside school were often not observed or assessed. Conclusions: The school-based application of multicomponent intervention strategies was the most consistent, promising strategy, while controversy existed regarding the effectiveness of family involvement, focus on healthy populations at increased risk or duration and intensity of the intervention. All 20 trials in the review update showed a positive effect on in-school, out-of-school or overall PA, and 6 of 11 studies showed an increase in fitness. Taking into consideration both assessment quality and public health relevance, multicomponent approaches in children including family components showed the highest level of evidence for increasing overall PA. This review confirms the public health potential of high quality, school-based PA interventions for increasing PA and possibly fitness in healthy youth.
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Physical activity practice during school days increases moderate to vigorous physical activity levels, improves aerobic fitness, and has positive learning outcomes and consequently academic achievement.
“Especially in children, physical activity practice during school days can be incorporated, and it increases moderate to vigorous physical activity levels (20) and improve aerobic fitness (4) and also has positive learning outcomes and consequently academic achievement (21).”
From Does Learning Through Movement Improve Academic Performance in Primary Schoolchildren? A Systematic Review (2022) · cites this paper as [4]
There is some evidence that intervention strategies based at the school, home/family or community/neighbourhood level can increase physical activity in children and adolescents.
“There is some evidence that intervention strategies based at the school, home/family or community/neighbourhood level can increase physical activity in children and adolescents.115–120”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [115]
Strong evidence indicates that multi-component interventions are effective in the promotion of physical activity in the school setting.
“Strong evidence indicates that multi-component interventions are effective in the promotion of PA (14, 63–69).”
From How can physical activity be promoted among children and adolescents? A systematic review of reviews across settings (2019) · cites this paper as [14]
Multi-component interventions are more effective than single-component interventions in the school setting.
“While multi-component interventions are more effective than single-component interventions (14, 70) they do not seem to produce synergistic results (63, 71).”
From How can physical activity be promoted among children and adolescents? A systematic review of reviews across settings (2019) · cites this paper as [14]
Numerous reviews reported positive effects when involving families in school-based interventions.
“Numerous reviews reported positive effects when involving parents (63, 66, 71, 74, 84, 85) and families (14, 65, 70) in school-based interventions.”
From How can physical activity be promoted among children and adolescents? A systematic review of reviews across settings (2019) · cites this paper as [14]
The integration of other components in addition to physical activity was considered a stumbling block for success.
“The integration of other components in addition to PA was considered as a “stumbling block for success” (14).”
From How can physical activity be promoted among children and adolescents? A systematic review of reviews across settings (2019) · cites this paper as [14]
A review of reviews found strong evidence for the positive effect of school-based interventions on physical activity in youth and confirmed the public health potential of high-quality, school-based physical activity interventions.
“A review of these reviews found strong evidence for the positive effect of school-based interventions on PA in youth and confirmed the public health potential of high-quality, school-based PA interventions.33”
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 [33]
School-based multi-component interventions are well supported as effective approaches to impact adolescent physical activity levels.
“Schoolbased multi-component interventions are well supported as effective approaches to impact adolescent PA levels (Kriemler et al., 2011;Pearson et al., 2015;Van Sluijs, McMinn, & Griffin, 2007).”
From The effectiveness of school-based physical activity interventions for adolescent girls: a systematic review and meta-analysis (2017) · cites this paper as Kriemler et al., 2011
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“(14) dealt with the effects of school-based interventions on PA and fitness in children and adolescents.”
BackgroundHynynen, S.-T., van Stralen, M. M., Sniehotta, F. F., Araújo-Soares, V., Hardeman, W., Chinapaw, M. J. M., Vasankari, T., & Hankonen, N. (2016) · International Review of Sport and Exercise Psychology · doi:10.1080/1750984x.2015.1081706 · Cited by 253 · see citing works
“INTERNATIONAL REVIEW OF SPORT AND EXERCISE PSYCHOLOGY 23 The heterogeneity in effectiveness of school-based PA interventions (see, e.g., Kriemler et al., 2011; van Sluijs et al., 2007) may be explained by differences in factors such as length of the intervention, mode of delivery, provider or…”
BackgroundChange in objectively measured physical activity during the transition to adolescence
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“32 A review of these reviews found strong evidence for the positive effect of school-based interventions on PA in youth and confirmed the public health potential of high-quality, school-based PA interventions.(33) However, existing reviews of PA interventions in school settings have examined evidence across childhood…”
BackgroundThe Effect of School Recess Interventions on Physical Activity: A Systematic Review
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- Authors
- Kriemler, S., Meyer, U., Martin, E., van Sluijs, E. M. F., Andersen, L. B., & Martin, B. W.
- Affiliations
- Swiss Tropical and Public Health Institute (CH)
- University of Zurich (CH)
- University of Southern Denmark (DK)
- Corresponding author
- Kriemler, S
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2011-08-11
- Volume
- 45
- Issue
- 11
- Pages
- 923-930
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- PMC
- PMC3841814
- OpenAlex
- W2165908922
- Cited by
- 827
- References
- 124
- Citations by year
- 2026: 27 · 2025: 43 · 2024: 30 · 2023: 33 · 2022: 61 · 2021: 94 · 2020: 94 · 2019: 64 · 2018: 55 · 2017: 66 · 2016: 72 · 2015: 66 · 2014: 61 · 2013: 40 · 2012: 16
- FWCI
- 4.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Wellcome Trust (087636)
- Economic and Social Research Council (ES/G007462/1)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- school-based intervention, physical activity, physical fitness, children, adolescents, multicomponent intervention, family involvement, intervention effectiveness, healthy youth
- MeSH terms
- Systematic Reviews as Topic, Adolescent, Child, Health Promotion, Health Status, Humans, Motor Skills, Physical Fitness, Prognosis, School Health Services, Exercise, Randomized Controlled Trials as Topic
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