A program evaluation of an in-school daily physical activity initiative for children and youth
Open accessAbstract
BACKGROUND: The school system is one setting in which children's physical activity levels may be increased through daily physical activity (DPA) policies and initiatives. Adherence to DPA policies is typically poor and results are limited in regard to the associated benefits for participating children. Therefore, the purpose of this study was to evaluate a range of psychosocial outcomes following a community-led, in-school DPA initiative for 9-14 year old children and youth. METHODS: This program evaluation examined the impact of a DPA program consisting of 20 min of teacher-led DPA for 20 consecutive weeks. Student outcomes were measured using a questionnaire administered at three time points: baseline, mid-intervention, and post-intervention. A teacher questionnaire regarding program adherence and student behaviour was completed at post-intervention. Mixed effects models were used to test for intervention effects, with random intercepts for students, classes, and schools, as well as fixed effects for age and sex. Due to the large number of outcomes measured, we first conducted an omnibus test of the intervention effect followed by three exploratory analyses examining each outcome separately, associations between outcomes and program adherence, and results from the teacher survey. RESULTS: Thirty classes (N = 19 experimental) from 7 schools participated in the study, with a total of 362 children (n = 265 experimental). There was no significant overall effect of the intervention (z = 0.89, p = 0.38) and the exploratory analyses demonstrated significant differences only for self-esteem and subjective happiness, with the control group slightly increasing relative to the experimental group. Teacher-reported adherence to the program was poor with only 21% of teachers adhering to the program. There was no association between overall adherence and student reported outcomes; however, positive correlations were present between adherence and teacher-reported student behaviour. CONCLUSIONS: The DPA program evaluated here did not improve the psychosocial well-being of elementary school-aged children more than usual practices. However, adherence to the program was poor and it did not have a negative effect on the students. Future work is needed on how best to support DPA implementation in the context of the school day and how student well-being may be positively impacted through school-based physical activity. TRIAL REGISTRATION: Program Evaluation of an in-school Daily Physical Activity Initiative NCT03618927 , August 6, 2018. Retrospectively registered.
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In addition to the 22 studies included in the original review, eight further studies were identified as eligible.
“In addition to the 22 studies included in the original review, eight further studies were identified as eligible.”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Studies were conducted between 1985 and 2018, with the duration of the studies varying from 20 weeks to 4 years.
“Studies were conducted between 1985 [59] and 2018 [65], with the duration of the studies varying from 20 weeks [26] to 4 years [49].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
The field of implementation science is rapidly evolving and a number of implementation studies targeting healthy eating and physical activity policies, practices, and programs have been published in recent years.
“The field of implementation science, however, is rapidly evolving and a number of implementation studies targeting healthy eating and physical activity policies, practices, and programs have been published in recent years [26–28].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
The risk of attrition was assessed as unclear in six studies, as insufficient information regarding the loss of schools and treatment of missing data were provided.
“The risk of attrition was assessed as unclear in six studies, as insufficient information regarding the loss of schools and treatment of missing data were provided [26, 37, 41, 42, 54, 57].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Seventeen of the included studies were assessed as high risk of detection bias.
“Seventeen of the included studies were assessed as high risk [26, 28, 37, 41, 43, 44, 46–49, 52, 54–56, 58, 66, 67] and seven studies were assessed as low risk of detection bias [27, 42, 51, 53, 60, 62, 63].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
No study tested the effectiveness of just one implementation strategy and only two studies tested the same combination of strategies.
“No study tested the effectiveness of just one implementation strategy and only two studies [26, 38] tested the same combination of strategies.”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Nine studies, including eight with nonrandomized designs, were assessed as high risk of selection bias.
“Nine studies, including eight with nonrandomized designs, were assessed as high risk of selection bias [26, 39, 43, 48, 49, 51, 52, 57, 61].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Ten studies were assessed as low risk of selective reporting as a trial registration or a published protocol paper was identified and all a priori determined outcomes were reported.
“Ten studies were assessed as low risk of selective reporting as a trial registration or a published protocol paper was identified and all a priori determined outcomes were reported [26, 44, 51, 53, 54, 60, 62–64, 67].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Seven studies were assessed as unclear for potential risk of recruitment to cluster.
“Seven studies were assessed as unclear [26, 37, 38, 41, 42, 46, 67], whilst the remaining study [27] was assessed as high risk of bias due to randomization occurring prior to recruitment and a lack of blinding of recruiters.”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Three studies were assessed as high risk for baseline imbalance.
“Three studies were assessed as high risk [26, 27, 42], while the remaining study [54] was at unclear risk of bias due to baseline imbalance.”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Of the seven nonrandomized studies, three were considered as high risk of confounding.
“Of the seven nonrandomized studies, three were considered as high risk of confounding [26, 52, 59], while it was unclear in the remaining five studies whether confounders had been sufficiently adjusted for [39, 43, 57, 61, 67].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Risk of contamination was assessed as low for the majority of clustered studies (n = 11), with only two studies assessed as high and the remaining two studies unclear.
“Risk of contamination was assessed as low for the majority of clustered studies (n = 11), with only two studies assessed as high [42, 55] and the remaining two studies unclear [26, 37].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
The remaining four studies were at unclear risk of bias due to incorrect analysis.
“Three studies were high risk of bias due to incorrect analysis [42, 46, 58], while eight studies were assessed as low risk [27, 37, 38, 41, 54, 56, 64, 67] and the remaining studies (n = 4) at unclear risk [26, 47, 55, 60].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
No significant improvements were reported in measures of quality of PE lessons in a more recent study by Bremer et al. among schools receiving implementation support.
“but not in measures of quality of PE lessons in a more recent study by Bremer et al. [26] among schools receiving implementation support.”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Studies tested a range of multicomponent implementation strategies, with only two studies testing the same combination.
“Studies tested a range of multicomponent implementation strategies, with only two studies testing the same combination [26, 38].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
Three studies compared implementation strategies to a usual care or minimal support control on measures of lesson quality.
“Three studies compared implementation strategies to a usual care or minimal support control on measures of lesson quality [26, 56, 60].”
From Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review (2021) · cites this paper as [26]
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- Authors
- Bremer, E., Graham, J. D., Veldhuizen, S., & Cairney, J.
- Affiliations
- McMaster University (CA)
- University of Toronto (CA)
- Corresponding author
- Cairney, John
- Venue
- BMC Public Health
- Published
- 2018-08-16
- Volume
- 18
- Issue
- 1
- Pages
- 1023-1023
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC6097410
- OpenAlex
- W2886104497
- Cited by
- 23
- References
- 48
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 1 · 2019: 1
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- TSpace (University of Toronto) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Department of Family Medicine, McMaster University (N/A)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Physical Education and Pedagogy
- Keywords
- daily physical activity, school-based physical activity, program adherence, psychosocial well-being, self-esteem, subjective happiness, elementary school students, youth, student behavior, program evaluation
- MeSH terms
- Adolescent, Child, Female, Humans, Male, Surveys and Questionnaires, School Health Services, Students, Program Evaluation, Exercise
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