Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54)

Metcalf, B.; Henley, W.; Wilkin, T.

doi:10.1136/bmj.e5888

Cited by 658Physical Activity and HealthObesity, Physical Activity, DietChildren's Physical and Motor Development

Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54)

Open access

Metcalf, B., Henley, W., Wilkin, T.·2012·BMJ

DOI 10.1136/bmj.e5888

Open this paper in CoChat — free account

Abstract

OBJECTIVE: To determine whether, and to what extent, physical activity interventions affect the overall activity levels of children. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Electronic databases (Embase, Medline, PsycINFO, SPORTDiscus) and reference lists of included studies and of relevant review articles. STUDY SELECTION: Design: randomised controlled trials or controlled clinical trials (cluster and individual) published in peer reviewed journals. INTERVENTION: incorporated a component designed to increase the physical activity of children/adolescents and was at least four weeks in duration. OUTCOMES: measured whole day physical activity objectively with accelerometers either before or immediately after the end of the intervention period. DATA ANALYSIS: INTERVENTION effects (standardised mean differences) were calculated for total physical activity, time spent in moderate or vigorous physical activity, or both for each study and pooled using a weighted random effects model. Meta-regression explored the heterogeneity of intervention effects in relation to study participants, design, intervention type, and methodological quality. RESULTS: Thirty studies (involving 14,326 participants; 6153 with accelerometer measured physical activity) met the inclusion criteria and all were eligible for meta-analysis/meta-regression. The pooled intervention effect across all studies was small to negligible for total physical activity (standardised mean difference 0.12, 95% confidence interval 0.04 to 0.20; P<0.01) and small for moderate or vigorous activity (0.16, 0.08 to 0.24; P<0.001). Meta-regression indicated that the pooled intervention effect did not differ significantly between any of the subgroups (for example, for total physical activity, standardised mean differences were 0.07 for age <10 years and 0.16 for ≥ 10 years, P=0.19; 0.07 for body mass index across the entire range and 0.22 for exclusively overweight/obese children, P=0.07; 0.12 for study duration ≤ 6 months and 0.09 for >6 months, P=0.71; 0.15 for home/family based intervention and 0.10 for school based intervention, P=0.53; and 0.09 for higher quality studies and 0.14 for lower quality studies, P=0.52). CONCLUSIONS: This review provides strong evidence that physical activity interventions have had only a small effect (approximately 4 minutes more walking or running per day) on children's overall activity levels. This finding may explain, in part, why such interventions have had limited success in reducing the body mass index or body fat of children.

Integrity signals

Registry

Crossref · 10.1136/bmj.e5888

Cites

78 of 78 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

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?

These effect sizes are small but are comparable to findings from other school based interventions.
“These effect sizes are small but are comparable to findings from other school based interventions [86-88].”
From The World Health Organization's Health Promoting Schools framework: a Cochrane systematic review and meta-analysis (2015) · cites this paper as [88]
The effects of interventions using accelerometers to increase the overall physical activity of children and adolescents are generally reported to be negligible or small for moderate or vigorous-intensity physical activity interventions, regardless of age, BMI (overweight/obese) or implementation setting (home/family or school).
“However, the effects of interventions using accelerometers to increase the overall physical activity of children and adolescents are generally reported to be negligible or small for moderate or vigorous-intensity physical activity interventions, regardless of age, BMI (overweight/obese) or implementation setting (home/family or school).119”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [119]
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 [119]
A number of existing systematic reviews of school-based PA interventions, as well as Beets et al., highlighted the potential risk that the intervention might increase PA during actual intervention delivery but result in a compensatory decline elsewhere during the day.
“A number of existing systematic reviews of school-based PA interventions,28, 104 as well as Beets et al.,37 highlighted the potential risk that the intervention might increase PA during actual intervention delivery but result in a compensatory decline elsewhere during the day.”
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 [104]

Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823 · see citing works
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 65,406 · see citing works
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 · see citing works
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 · see citing works
Statistical Power Analysis for the Behavioral Sciences
Cohen, J. (2013) · doi:10.4324/9780203771587 · Cited by 25,373 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048 · see citing works
Introduction to Meta‐Analysis
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2021) · doi:10.1002/9781119558378 · Cited by 9,799 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions
Tarsilla, M. (2010) · Journal of MultiDisciplinary Evaluation · doi:10.56645/jmde.v6i14.284 · Cited by 5,227 · see citing works
Systematic review of the health benefits of physical activity and fitness in school-aged children and youth
Janssen, I., & LeBlanc, A. G. (2010) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-7-40 · Cited by 4,829 · see citing works
Interventions for preventing obesity in children
Brown, T. J., Moore, T. H., Hooper, L., Gao, Y., Zayegh, A. M., Ijaz, S., Elwenspoek, M. M. C., Foxen, S. C., Magee, L., O’Malley, C. L., et al. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001871.pub4 · Cited by 2,996 · see citing works
Physical activity and clustered cardiovascular risk in children: a cross-sectional study (The European Youth Heart Study)
Andersen, L. B., Harro, M., Sardinha, L. B., Froberg, K., Ekelund, U., Brage, S., & Anderssen, S. A. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69075-2 · Cited by 1,465 · see citing works
Interventions for preventing obesity in children
Waters, E., de Silva-Sanigorski, A., Burford, B. J., Brown, T., Campbell, K. J., Gao, Y., Armstrong, R., Prosser, L., & Summerbell, C. D. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001871.pub3 · Cited by 1,455 · see citing works
Moderate to Vigorous Physical Activity and Sedentary Time and Cardiometabolic Risk Factors in Children and Adolescents
Ekelund, U. (2012) · JAMA · doi:10.1001/jama.2012.156 · Cited by 1,158 · see citing works
Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials
van Sluijs, E. M. F., McMinn, A. M., & Griffin, S. J. (2007) · BMJ · doi:10.1136/bmj.39320.843947.be · Cited by 1,120 · see citing works
Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis
Marshall, S. J., Biddle, S., Gorely, T., Cameron, N., & Murdey, I. D. (2004) · International Journal of Obesity · doi:10.1038/sj.ijo.0802706 · Cited by 1,104 · see citing works
Validation and Calibration of Physical Activity Monitors in Children
Puyau, M. R., Adolph, A. L., Vohra, F. A., & Butte, N. F. (2002) · Obesity Research · doi:10.1038/oby.2002.24 · Cited by 1,024 · see citing works
Physical activity levels and patterns of 9- and 15-yr-old European children
RIDDOCH, C. J., BO ANDERSEN, L., WEDDERKOPP, N., HARRO, M., KLASSON-HEGGEBØ, L., SARDINHA, L. B., COOPER, A. R., & EKELUND, U. (2004) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000106174.43932.92 · Cited by 900 · see citing works
Pathways: a school-based, randomized controlled trial for the prevention of obesity in American Indian schoolchildren
Caballero, B. H., Clay, T., Davis, S. M., Ethelbah, B., Rock, B. H., Lohman, T. G., Norman, J. E., Story, M. T., Stone, E. J., Stephenson, L., et al. (2003) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/78.5.1030 · Cited by 628 · see citing works
Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial
Kriemler, S., Zahner, L., Schindler, C., Meyer, U., Hartmann, T., Hebestreit, H., Brunner-La Rocca, H. P., van Mechelen, W., & Puder, J. J. (2010) · BMJ · doi:10.1136/bmj.c785 · Cited by 524 · see citing works
Objective measurement of levels and patterns of physical activity
Riddoch, C., Mattocks, C., Deere, K. C., Saunders, J., Kirkby, J., Tilling, K. M., Leary, S. D., Blair, S. N., & Ness, A. (2007) · Archives of Disease in Childhood · doi:10.1136/adc.2006.112136 · Cited by 519 · see citing works
Effect of school-based physical activity interventions on body mass index in children: a meta-analysis
Harris, K. C., Kuramoto, L. K., Schulzer, M., & Retallack, J. E. (2009) · Canadian Medical Association Journal · doi:10.1503/cmaj.080966 · Cited by 497 · see citing works
Objectively Measured Physical Activity and Fat Mass in a Large Cohort of Children
Ness, A., Leary, S. D., Mattocks, C., Blair, S. N., Reilly, J. J., Wells, J. C. K., Ingle, S., Tilling, K. M., Smith, G. D., & Riddoch, C. (2007) · PLoS Medicine · doi:10.1371/journal.pmed.0040097 · Cited by 447 · see citing works
Physical Activity Reduces Systemic Blood Pressure and Improves Early Markers of Atherosclerosis in Pre-Pubertal Obese Children
Farpour-Lambert, N. J., Aggoun, Y., Marchand, L. M., Martin, X. E., Herrmann, F. R., & Beghetti, M. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.08.030 · Cited by 436 · see citing works
Validation of interviewer- and self- administered physical activity checklists for fifth grade students
Sallis, J. F., Strikmiller, P. K., Harsha, D. W., Feldman, H. A., Ehlinger, S., Stone, E. J., Williston, J. M., & Woods, S. E. (1996) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199607000-00011 · Cited by 421 · see citing works
Associations between objectively assessed physical activity and indicators of body fatness in 9- to 10-y-old European children: a population-based study from 4 distinct regions in Europe (the European Youth Heart Study)
Ekelund, U., Sardinha, L. B., Anderssen, S. A., Harro, M., Franks, P. W., Brage, S., Cooper, A. R., Andersen, L. B., Riddoch, C., & Froberg, K. (2004) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/80.3.584 · Cited by 419 · see citing works
Promoting physical activity participation among children and adolescents
Salmon, J., Booth, M. L., Phongsavan, P., Murphy, N., & Timperio, A. (2007) · Epidemiologic Reviews · doi:10.1093/epirev/mxm010 · Cited by 402 · see citing works
Behavioral interventions to prevent childhood obesity: a systematic review and metaanalyses of randomized trials
Kamath, C. C., Vickers, K. S., Ehrlich, A., McGovern, L., Johnson, J., Singhal, V., Paulo, R., Hettinger, A., Erwin, P. J., & Montori, V. M. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-2411 · Cited by 395 · see citing works
Physical activity to prevent obesity in young children: cluster randomised controlled trial
Reilly, J. J., Kelly, L. A., Montgomery, C., Williamson, A., Fisher, A., McColl, J. H., Conte, R. L., Paton, J. Y., & Grant, S. (2006) · BMJ · doi:10.1136/bmj.38979.623773.55 · Cited by 379 · see citing works
Promoting Physical Activity in Middle School Girls
Webber, L. S., Catellier, D., Lytle, L. A., Murray, D. M., PRATT, C. A., Young, D. R., Elder, J. P., Lohman, T. G., Stevens, J., Jobe, J. B., et al. (2008) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.11.018 · Cited by 318 · see citing works
Effects of active video games on body composition: a randomized controlled trial
Maddison, R., Foley, L. S., Mhurchú, C. N., Jiang, Y., Jull, A., Harry Prapavessis, A., Hohepa, M., & Rodgers, A. (2011) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.110.009142 · Cited by 274 · see citing works
Obesity Prevention in Preschool Native‐American Children: A Pilot Study Using Home Visiting
Harvey‐Berino, J., & ROURKE, J. (2003) · Obesity Research · doi:10.1038/oby.2003.87 · Cited by 248 · see citing works
Fatness leads to inactivity, but inactivity does not lead to fatness: a longitudinal study in children (EarlyBird 45)
Metcalf, B. S., Hosking, J., Jeffery, A., Voss, L. D., Henley, W., & Wilkin, T. J. (2010) · Archives of Disease in Childhood · doi:10.1136/adc.2009.175927 · Cited by 240 · see citing works
Self-citation
Effect of multidimensional lifestyle intervention on fitness and adiposity in predominantly migrant preschool children (Ballabeina): cluster randomised controlled trial
Puder, J. J., Marques-Vidal, P. M., Schindler, C., Zahner, L., Niederer, I., Bürgi, F., Ebenegger, V., Nydegger, A., & Kriemler, S. (2011) · BMJ · doi:10.1136/bmj.d6195 · Cited by 232 · see citing works
Video Game Play, Child Diet, and Physical Activity Behavior Change
Baranowski, T., Baranowski, J. C., Thompson, D. I., Buday, R., Jago, R., Griffith, M. J., Islam, N. G., Nguyen, N. T., & Watson, K. B. (2010) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2010.09.029 · Cited by 229 · see citing works
Hip‐Hop to Health Jr. Obesity Prevention Effectiveness Trial: Postintervention Results
Fitzgibbon, M., Stolley, M. R., Schiffer, L. A., Braunschweig, C. L., Gomez, S. L., Horn, L. V., & Dyer, A. R. (2010) · Obesity · doi:10.1038/oby.2010.314 · Cited by 209 · see citing works
Randomized Controlled Trial of a Primary Care and Home-Based Intervention for Physical Activity and Nutrition Behaviors: PACE+ for Adolescents
Patrick, K., Calfas, K. J., Norman, G. J., Zabinski, M. F., Sallis, J. F., Rupp, J., Covin, J., & Cella, J. (2006) · Archives of Pediatrics & Adolescent Medicine · doi:10.1001/archpedi.160.2.128 · Cited by 208 · see citing works
Outcomes of a group-randomized trial to prevent excess weight gain, reduce screen behaviours and promote physical activity in 10-year-old children: Switch-Play
Salmon, J., Ball, K., Hume, C., Booth, M., & Crawford, D. A. (2008) · International Journal of Obesity · doi:10.1038/sj.ijo.0803805 · Cited by 205 · see citing works
Outcomes and costs of primary care surveillance and intervention for overweight or obese children: the LEAP 2 randomised controlled trial
Wake, M. A., Baur, L. A., Gerner, B., Gibbons, K. L., Gold, L. H., Gunn, J. M., Levickis, P. A., McCallum, Z., Naughton, G. A., Sanci, L. A., et al. (2009) · BMJ · doi:10.1136/bmj.b3308 · Cited by 203 · see citing works
Effect Sizes Based on Means
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009) · doi:10.1002/9780470743386.ch4 · Cited by 202 · see citing works
Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity
McCallum, Z., Wake, M. A., Gerner, B., Baur, L. A., Gibbons, K. L., Gold, L. H., Gunn, J. M., Harris, C., Naughton, G. A., Riess, C., et al. (2006) · International Journal of Obesity · doi:10.1038/sj.ijo.0803509 · Cited by 199 · see citing works
Team Sports for Overweight Children
Weintraub, D. L., Tirumalai, E. C., Haydel, K. F., Fujimoto, M., Fulton, J. E., & Robinson, T. N. (2008) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2007.43 · Cited by 198 · see citing works
APPLE Project: 2-y findings of a community-based obesity prevention program in primary school–age children
Taylor, R. W., McAuley, K. A., Barbezat, W., Parry‐Strong, A., Williams, S., & Mann, J. I. (2007) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/86.3.735 · Cited by 187 · see citing works
Evaluation of a 2-year physical activity and healthy eating intervention in middle school children
Haerens, L. L., Deforche, B., Maes, L., Cardon, G., Stevens, V. K., & Bourdeaudhuij, I. D. (2006) · Health Education Research · doi:10.1093/her/cyl115 · Cited by 172 · see citing works
A Randomized Controlled Trial of Culturally Tailored Dance and Reducing Screen Time to Prevent Weight Gain in Low-Income African American Girls
Robinson, T. N., Matheson, D., KRAEMER, H. C., Wilson, D. M., Obarzanek, E., Thompson, N. S., Alhassan, S., Spencer, T. R., Haydel, K. F., Fujimoto, M., et al. (2010) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2010.197 · Cited by 166 · see citing works
Randomized, Controlled Trial of a Best-Practice Individualized Behavioral Program for Treatment of Childhood Overweight: Scottish Childhood Overweight Treatment Trial (SCOTT)
Hughes, A. R., Stewart, L., Chapple, J., McColl, J. H., Donaldson, M., Kelnar, C. J. H., Zabihollah, M., Ahmed, S. F., & Reilly, J. J. (2008) · PEDIATRICS · doi:10.1542/peds.2007-1786 · Cited by 165 · see citing works
Effectiveness of interventions to promote physical activity in children and adolescents: systematic review of controlled trials
Reading, R. (2008) · Child Care Health and Development · doi:10.1111/j.1365-2214.2008.00831_1.x · Cited by 149 · see citing works
Physical activity at the government-recommended level and obesity-related health outcomes: a longitudinal study (Early Bird 37)
Metcalf, B. S., Voss, L. D., Hosking, J., Jeffery, A., & Wilkin, T. J. (2008) · Archives of Disease in Childhood · doi:10.1136/adc.2007.135012 · Cited by 143 · see citing works
Self-citation
Physical activity, food intake, and body weight regulation: insights from doubly labeled water studies
Westerterp, K. R. (2010) · Nutrition Reviews · doi:10.1111/j.1753-4887.2010.00270.x · Cited by 141 · see citing works
Tracking of objectively measured physical activity from childhood to adolescence: The European youth heart study
Kristensen, P. L., Møller, N. C., Korsholm, L., Wedderkopp, N., Andersen, L. B., & Froberg, K. (2007) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2006.00622.x · Cited by 132 · see citing works
Effect of a school-based intervention to promote healthy lifestyles in 7-11 year old children
Gorely, T., Nevill, M. E., Morris, J. G., Stensel, D. J., & Nevill, A. (2009) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-6-5 · Cited by 127 · see citing works
A 4-year, cluster-randomized, controlled childhood obesity prevention study: STOPP
Marcus, C., Nyberg, G., Nordenfelt, A., Karpmyr, M., Kowalski, J. H., & Ekelund, U. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.38 · Cited by 127 · see citing works
Intraindividual Variation of Objectively Measured Physical Activity in Children
MATTOCKS, C., LEARY, S., NESS, A., DEERE, K., SAUNDERS, J., KIRKBY, J., BLAIR, S. N., TILLING, K., & RIDDOCH, C. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318030631b · Cited by 125 · see citing works
Multiple Outcomes or Time‐Points within a Study
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009) · doi:10.1002/9780470743386.ch24 · Cited by 124 · see citing works
Effects of Open-Loop Feedback on Physical Activity and Television Viewing in Overweight and Obese Children: A Randomized, Controlled Trial
Goldfield, G. S., Mallory, R., Parker, T., Cunningham, T., Legg, C., Lumb, A., Parker, K., Prud’homme, D., Gaboury, I., & Adamo, K. B. (2006) · PEDIATRICS · doi:10.1542/peds.2005-3052 · Cited by 119 · see citing works
Fit for Life Boy Scout badge: Outcome evaluation of a troop and Internet intervention
Jago, R., Baranowski, T., Baranowski, J. C., Thompson, D. I., Cullen, K. W., Watson, K., & Liu, Y. (2006) · Preventive Medicine · doi:10.1016/j.ypmed.2005.12.010 · Cited by 119 · see citing works
The Memphis Girls' health Enrichment Multi-site Studies (GEMS)
Klesges, R. C., Obarzanek, E., Kumanyika, S., Murray, D. M., Klesges, L. M., Relyea, G. E., Stockton, M. B., Lanctot, J. Q., Beech, B. M., McClanahan, B. S., et al. (2010) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpediatrics.2010.196 · Cited by 115 · see citing works
Predicting Energy Expenditure from Accelerometry Counts in Adolescent Girls
Schmitz, K. H., Treuth, M. S., Hannan, P. J., McMurray, R. G., Ring, K. B., Catellier, D., & PATE, R. R. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000150084.97823.f7 · Cited by 113 · see citing works
Promoting healthy lifestyles among adolescent boys: The Fitness Improvement and Lifestyle Awareness Program RCT
Peralta, L. R., Jones, R. A., & Okely, A. D. (2009) · Preventive Medicine · doi:10.1016/j.ypmed.2009.04.007 · Cited by 104 · see citing works
A comprehensive physical activity promotion programme at elementary school: the effects on physical activity, physical fitness and psychosocial correlates of physical activity
Verstraete, S. J., Cardon, G. M., De Clercq, D. L., & De Bourdeaudhuij, I. M. (2007) · Public Health Nutrition · doi:10.1017/s1368980007223900 · Cited by 104 · see citing works
Results of the “Active by Choice Today” (ACT) randomized trial for increasing physical activity in low-income and minority adolescents.
Wilson, D. K., Van Horn, M. L., Kitzman-Ulrich, H., Saunders, R., Pate, R., Lawman, H. G., Hutto, B., Griffin, S., Zarrett, N., Addy, C. L., et al. (2011) · Health Psychology · doi:10.1037/a0023390 · Cited by 103 · see citing works
Interactive Multimedia for Promoting Physical Activity (IMPACT) in Children
Goran, M. I., & Reynolds, K. D. (2005) · Obesity Research · doi:10.1038/oby.2005.86 · Cited by 100 · see citing works
A preliminary test of a student-centered intervention on increasing physical activity in underserved adolescents
Wilson, D. K., Evans, A. E., Williams, J. E., Mixon, G., Sirard, J. R., & Pate, R. R. (2005) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm3002_4 · Cited by 100 · see citing works
Validity and Reliability of the Fels Physical Activity Questionnaire for Children
Treuth, M. S., Hou, N., Young, D. R., & Maynard, L. M. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000155392.75790.83 · Cited by 94 · see citing works
Surveillance of physical activity in the UK is flawed: validation of the Health Survey for England Physical Activity Questionnaire
Basterfield, L., Adamson, A., Parkinson, K. N., Maute, U., Li, P. X., Reilly, J. J., & the Gateshead Millennium Study Core Team (2008) · Archives of Disease in Childhood · doi:10.1136/adc.2007.135905 · Cited by 91 · see citing works
The Effect of a Physical Activity Intervention on Bias in Self-Reported Activity
Taber, D. R., Stevens, J., Murray, D. M., Elder, J. P., Webber, L. S., Jobe, J. B., & Lytle, L. A. (2009) · Annals of Epidemiology · doi:10.1016/j.annepidem.2009.01.001 · Cited by 87 · see citing works
The impact of school-time activity on total physical activity: the activitystat hypothesis (EarlyBird 46)
Frémeaux, A. E., Mallam, K. M., Metcalf, B. S., Hosking, J., Voss, L. D., & Wilkin, T. J. (2011) · International Journal of Obesity · doi:10.1038/ijo.2011.52 · Cited by 86 · see citing works
Self-citation
Movement Skills and Physical Activity in Obese Children
Cliff, D. P., Okely, A. D., Morgan, P. J., Steele, J. R., Jones, R. A., Colyvas, K., & Baur, L. A. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181e741e8 · Cited by 83 · see citing works
Open-Loop Feedback Increases Physical Activity of Youth
Roemmich, J. N., Gurgol, C. M., & Epstein, L. H. (2004) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000121947.59529.3b · Cited by 78 · see citing works
Evidence of the influence of physical activity on the metabolic syndrome and/or on insulin resistance in pediatric populations: a systematic review
Guinhouya, B. C., Samouda, H., Zitouni, D., Vilhelm, C., & Hubert, H. (2011) · International Journal of Pediatric Obesity · doi:10.3109/17477166.2011.605896 · Cited by 72 · see citing works
Assessment of a two-year school-based physical activity intervention among 7-9-year-old children
Magnusson, K., Sigurgeirsson, I., Sveinsson, T., & Johannsson, E. (2011) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-8-138 · Cited by 71 · see citing works
Stability of Habitual Physical Activity and Sedentary Behavior Monitoring by Accelerometry in 6- to 8-Year-Olds
Basterfield, L., Adamson, A., Pearce, M. S., & Reilly, J. J. (2011) · Journal of Physical Activity and Health · doi:10.1123/jpah.8.4.543 · Cited by 71 · see citing works
Randomized controlled trial of a good practice approach to treatment of childhood obesity in Malaysia: Malaysian Childhood Obesity Treatment Trial (MASCOT)
Wafa, S. W., Talib, R. A., Hamzaid, N. A., McColl, J. H., Rajikan, R., Ng, L. O., Ramli, A., & Reilly, J. J. (2011) · International Journal of Pediatric Obesity · doi:10.3109/17477166.2011.566340 · Cited by 56 · see citing works
Physical Activity Levels of High School Students—United States, 2010
Fulton, J. E., Carroll, D. D., Galuska, D. A., Lee, S. M., Eaton, D. K., Brener, N. D., & Song, M. (2011) · JAMA · doi:10.1001/jama.306.4.367 · Cited by 52 · see citing works
Improvement of aerobic fitness in obese children: a meta-analysis
Saavedra, J. M., Escalante, Y., & García‐Hermoso, A. (2011) · International Journal of Pediatric Obesity · doi:10.3109/17477166.2011.579975 · Cited by 46 · see citing works
Effects of a 2-year lifestyle intervention on physical activity in overweight and obese children
Bäcklund, C., Sundelin, G., & Larsson, C. L. (2011) · Advances in Physiotherapy · doi:10.3109/14038196.2011.562540 · Cited by 17 · see citing works
Promoting Physical Activity in Middle School Girls: Trial of Activity for Adolescent Girls
Lohman, T. G., Elder, J. P., Lytle, L. A., et al. (2020) · Carolina Digital Repository (University of North Carolina at Chapel Hill) · doi:10.17615/37ak-hc52 · Cited by 17 · see citing works
Effect of a 1-year lifestyle intervention on physical activity in overweight and obese children
Bäcklund, C., Sundelin, G., & Larsson, C. L. (2011) · Advances in Physiotherapy · doi:10.3109/14038196.2011.566353 · Cited by 14 · see citing works
Reporting the Results of a Meta‐Analysis
Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009) · doi:10.1002/9780470743386.ch41 · Cited by 10 · see citing works

Flagged first, then by citations

Sorted by citations

Advancing social connection as a public health priority in the United States.
Holt-Lunstad, J., Robles, T. F., & Sbarra, D. A. (2017) · American Psychologist · doi:10.1037/amp0000103 · Cited by 978 · see citing works
Physical activity behaviours in adolescence: Current evidence and opportunities for intervention
van Sluijs, E. M. F., Ekelund, U., Crochemore-Silva, I., Guthold, R., Ha, A., Lubans, D., Oyeyemi, A. L., Ding, D., & Katzmarzyk, P. T. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01259-9 · Cited by 919 · see citing works
The World Health Organization's Health Promoting Schools framework: a Cochrane systematic review and meta-analysis
Langford, R., Bonell, C., Jones, H., Pouliou, T., Murphy, S., Waters, E., Komro, K., Gibbs, L., Magnus, D., & Campbell, R. (2015) · BMC Public Health · doi:10.1186/s12889-015-1360-y · Cited by 578 · see citing works
“While HPS effect sizes are broadly similar to results from other school-based systematic reviews [86-88,97,98], the latter often include different types of interventions ranging from ‘curriculum only’ interventions to more comprehensive programmes making meaningful comparisons difficult.”
Result
Are school-based physical activity interventions effective and equitable? A meta-analysis of cluster randomized controlled trials with accelerometer-assessed activity
Love, R., Adams, J., & van Sluijs, E. M. F. (2019) · Obesity Reviews · doi:10.1111/obr.12823 · Cited by 452 · see citing works
Do School-Based Interventions Focusing on Physical Activity, Fitness, or Fundamental Movement Skill Competency Produce a Sustained Impact in These Outcomes in Children and Adolescents? A Systematic Review of Follow-Up Studies
Lai, S. K., Costigan, S. A., Morgan, P. J., Lubans, D. R., Stodden, D. F., Salmon, J., & Barnett, L. M. (2014) · Sports Medicine · doi:10.1007/s40279-013-0099-9 · Cited by 291 · see citing works
A systematic review of school-based interventions targeting physical activity and sedentary behaviour among older adolescents
Hynynen, 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
Effect of intervention aimed at increasing physical activity, reducing sedentary behaviour, and increasing fruit and vegetable consumption in children: active for life year 5 (AFLY5) school-based cluster randomised controlled trial
Kipping, R. R., Howe, L. D., Jago, R., Campbell, R., Wells, S., Chittleborough, C. R., Mytton, J., Noble, S. M., Peters, T. J., & Lawlor, D. A. (2014) · BMJ · doi:10.1136/bmj.g3256 · Cited by 221 · see citing works
Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)
Chen, P., Wang, D., Shen, H., Yu, L., Gao, Q., Mao, L., Jiang, F., Luo, Y., Xie, M., Zhang, Y., et al. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-102261 · Cited by 225 · see citing works
The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion
Beets, M. W., Okely, A., Weaver, R. G., Webster, C., Lubans, D., Brusseau, T., Carson, R., & Cliff, D. P. (2016) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-016-0442-2 · Cited by 205 · see citing works
A mixed-studies systematic review and meta-analysis of school-based interventions to promote physical activity and/or reduce sedentary time in children
Jones, M., Defever, E., Letsinger, A., Steele, J., & Mackintosh, K. A. (2020) · Journal of Sport and Health Science · doi:10.1016/j.jshs.2019.06.009 · Cited by 189 · see citing works
“Whilst the finding of no evidence of effect for PA or MVPA and inconclusive evidence for ST is a disappointing outcome for public health practitioners and researchers who consider the school a promising setting for interventions, it is important to understand why attempts to increase children’s PA levels and reduce ST…”
Background
Methodological considerations and impact of school‐based interventions on objectively measured physical activity in adolescents: a systematic review and meta‐analysis
Borde, R., Smith, J. J., Sutherland, R., Nathan, N., & Lubans, D. R. (2017) · Obesity Reviews · doi:10.1111/obr.12517 · Cited by 177 · see citing works
Physical Activity and Skills Intervention: SCORES Cluster Randomized Controlled Trial
COHEN, K. E., MORGAN, P. J., PLOTNIKOFF, R. C., CALLISTER, R., & LUBANS, D. R. (2015) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000452 · Cited by 150 · see citing works
Increasing physical activity in young primary school children: it's child's play: a cluster randomised controlled trial
Engelen, L., Bundy, A. C., Naughton, G., Simpson, J. M., Bauman, A., Ragen, J., Baur, L., Wyver, S., Tranter, P., Niehues, A., et al. (2013) · Preventive Medicine · doi:10.1016/j.ypmed.2013.02.007 · Cited by 152 · see citing works
Organized Sport Participation Is Associated with Higher Levels of Overall Health-Related Physical Activity in Children (CHAMPS Study-DK)
Hebert, J. J., Møller, N. C., Andersen, L. B., & Wedderkopp, N. (2015) · PLOS ONE · doi:10.1371/journal.pone.0134621 · Cited by 151 · see citing works
Compensation of Physical Activity and Sedentary Time in Primary School Children
RIDGERS, N. D., TIMPERIO, A., CERIN, E., & SALMON, J. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000275 · Cited by 118 · see citing works
The Physical Activity 4 Everyone Cluster Randomized Trial
Sutherland, R. L., Campbell, E. M., Lubans, D. R., Morgan, P. J., Nathan, N. K., Wolfenden, L., Okely, A. D., Gillham, K. E., Hollis, J. L., Oldmeadow, C. J., et al. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.02.020 · Cited by 118 · see citing works
Effectiveness of a Multifaceted Intervention for Prevention of Obesity in Primary School Children in China: A Cluster Randomized Clinical Trial
Liu, Z., Gao, P., Gao, A.-Y., Lin, Y., Feng, X.-X., Zhang, F., Xu, L.-Q., Niu, W.-Y., Fang, H., Zhou, S., et al. (2022) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2021.4375 · Cited by 116 · see citing works
Systematic review and meta-analysis of health promotion interventions for children and adolescents using an ecological framework
Cushing, C. C., Brannon, E. E., Suorsa, K. I., & Wilson, D. K. (2014) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsu042 · Cited by 110 · see citing works
Evaluation of physical activity interventions in children via the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework: a systematic review of randomized and non-randomized trials
McGoey, T., Root, Z., Bruner, M. W., & Law, B. (2016) · Preventive Medicine · doi:10.1016/j.ypmed.2015.11.004 · Cited by 93 · see citing works
Effect and cost of an after-school dance programme on the physical activity of 11–12 year old girls: The Bristol Girls Dance Project, a school-based cluster randomised controlled trial
Jago, R., Edwards, M. J., Sebire, S. J., Tomkinson, K., Bird, E. L., Banfield, K., May, T., Kesten, J. M., Cooper, A. R., Powell, J. E., et al. (2015) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-015-0289-y · Cited by 94 · see citing works
Do extra compulsory physical education lessons mean more physically active children - findings from the childhood health, activity, and motor performance school study Denmark (The CHAMPS-study DK)
Møller, N. C., Tarp, J., Kamelarczyk, E. F., Brønd, J. C., Klakk, H., & Wedderkopp, N. (2014) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-014-0121-0 · Cited by 93 · see citing works
Impact of trained champions of comprehensive school physical activity programs on school physical activity offerings, youth physical activity and sedentary behaviors
Carson, R. L., Castelli, D. M., Pulling Kuhn, A. C., Moore, J. B., Beets, M. W., Beighle, A., Aija, R., Calvert, H. G., & Glowacki, E. M. (2014) · Preventive Medicine · doi:10.1016/j.ypmed.2014.08.025 · Cited by 81 · see citing works
Changes in time-segment specific physical activity between ages 10 and 14 years: A longitudinal observational study
Brooke, H. L., Atkin, A. J., Corder, K., Ekelund, U., & van Sluijs, E. M. F. (2016) · Journal of Science and Medicine in Sport · doi:10.1016/j.jsams.2014.10.003 · Cited by 70 · see citing works
Evaluation of physical activity interventions in youth via the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework: A systematic review of randomised and non-randomised trials
McGoey, T., Root, Z., Bruner, M. W., & Law, B. (2015) · Preventive Medicine · doi:10.1016/j.ypmed.2015.04.006 · Cited by 61 · see citing works
Impact of recess interventions on children's physical activity-a meta-analysis
Erwin, H. E., Ickes, M., Ahn, S., & Fedewa, A. (2014) · American Journal of Health Promotion · doi:10.4278/ajhp.120926-lit-470 · Cited by 66 · see citing works
The effect of increasing risk and challenge in the school playground on physical activity and weight in children: A cluster randomised controlled trial (PLAY)
Farmer, V. L., Williams, S. M., Mann, J. I., Schofield, G., McPhee, J. C., & Taylor, R. W. (2017) · International Journal of Obesity · doi:10.1038/ijo.2017.41 · Cited by 60 · see citing works
Co-designing obesity prevention interventions together with children: intervention mapping meets youth-led participatory action research
Anselma, M., Altenburg, T. M., Emke, H., van Nassau, F., Jurg, M., Ruiter, R. A. C., Jurkowski, J. M., & Chinapaw, M. J. M. (2019) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-019-0891-5 · Cited by 55 · see citing works
Effects of before-school physical activity on obesity prevention and wellness
Whooten, R. C., Perkins, M. E., Gerber, M. W., & Taveras, E. M. (2018) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2018.01.017 · Cited by 41 · see citing works
The impact of school uniforms on primary school student's physical activity at school: outcomes of a cluster randomized controlled trial
Nathan, N., McCarthy, N., Hope, K., Sutherland, R., Lecathelinais, C., Hall, A., Lane, C., Trost, S., Yoong, S. L., & Wolfenden, L. (2021) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-021-01084-0 · Cited by 39 · see citing works
Trends in physical fitness among 12-year-old children in urban and rural areas during the social transformation period in China
Ao, D., Wu, F., Yun, C.-F., & Zheng, X.-Y. (2019) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2018.08.021 · Cited by 39 · see citing works
Physical activity and prevention of chronic disease in Chinese youth: a public health approach
Li, F., Mao, L., & Chen, P. (2019) · Journal of Sport and Health Science · doi:10.1016/j.jshs.2019.06.008 · Cited by 34 · see citing works
Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review
Marin, T. S., Kourbelis, C., Foote, J., Newman, P., Brown, A., Daniel, M., Coffee, N. T., Nicholls, S. J., Ganesan, A., Versace, V. L., et al. (2019) · European Journal of Preventive Cardiology · doi:10.1177/2047487318805580 · Cited by 33 · see citing works
Interventions to increase physical activity in children aged 2-5 years: a systematic review
Ling, J., Robbins, L. B., Wen, F., & Peng, W. (2015) · Pediatric Exercise Science · doi:10.1123/pes.2014-0148 · Cited by 28 · see citing works
Family-based interventions to increase physical activity in children: a meta-analysis and realist synthesis protocol
Brown, H. E., Atkin, A. J., Panter, J., Corder, K., Wong, G., Chinapaw, M. J. M., & van Sluijs, E. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-005439 · Cited by 20 · see citing works
Systematic Review Shows Only Few Reliable Studies of Physical Activity Intervention in Adolescents
Soares, N. M. M., Leão, A. S., Santos, J. R., Monteiro, G. R., Santos, J. R. D., Thomazzi, S. M., & Silva, R. J. D. S. (2014) · The Scientific World Journal · doi:10.1155/2014/206478 · Cited by 5 · see citing works

Authors: Metcalf, B., Henley, W., & Wilkin, T.
Affiliations: Peninsula College of Medicine and Dentistry (GB)
University of Exeter (GB)
Corresponding author: Metcalf, B.
ORCID: Metcalf, B.
Henley, W.
Venue: BMJ
Publisher: BMJ
Published: 2012-09-27
Volume: 345
Issue: sep27 1
Pages: e5888-e5888
ISSN: 1756-1833 (ISSN-L)
DOI: 10.1136/bmj.e5888
OpenAlex: W2025533609
Cited by: 658
References: 78
Citations by year: 2026: 13 · 2025: 21 · 2024: 36 · 2023: 26 · 2022: 66 · 2021: 49 · 2020: 58 · 2019: 51 · 2018: 51 · 2017: 57 · 2016: 83 · 2015: 59 · 2014: 46 · 2013: 35 · 2012: 7
FWCI: 4.99
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: BMJ (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Figshare (submittedVersion)
Open Research Exeter (University of Exeter) (submittedVersion)
Funders: National Institute for Health and Care Research
Topics: Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
Keywords: physical activity interventions, children, adolescents, moderate-to-vigorous physical activity, accelerometer-measured activity, intervention effectiveness, school-based intervention, home-based intervention, body mass index, overweight and obesity, intervention quality, study duration, physical activity promotion, sedentary behavior, sleep duration, screen time
MeSH terms: Adolescent, Child, Clinical Trials as Topic, Female, Health Promotion, Humans, Male, Motor Activity, Obesity, 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.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Effectiveness of intervention on physical activity of children: systematic review and meta-analysis of controlled trials with objectively measured outcomes (EarlyBird 54)

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks