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Cited by 259Physical Activity and HealthObesity, Physical Activity, DietSchool Health and Nursing Education

How can physical activity be promoted among children and adolescents? A systematic review of reviews across settings

Open access
Messing, Sven, Rütten, Alfred, Abu-Omar, Karim, Ungerer-Röhrich, Ulrike, Goodwin, Lee, Burlacu, Ionuţ, Gediga, Günther·2019·Frontiers in Public Health
DOI 10.3389/fpubh.2019.00055PMC PMC6433781
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Abstract

Introduction: A vast majority of children and adolescents are physically inactive. As a result, high obesity rates and related diseases have made physical activity promotion a politically relevant topic. In order to form the basis for political decision making, evidence is required regarding the efficacy and effectiveness of interventions for physical activity promotion. In contrast to previous research, this systematic review of reviews targets three key settings (family and home, childcare, school), and is among the largest to have been conducted. Methods: A systematic review of reviews was conducted as part of a large-scale project to develop national recommendations for physical activity promotion in Germany. Six electronic databases were searched and inclusion criteria were defined. Two independent reviewers screened the titles and abstracts of potentially relevant literature. 213 reviews were identified and categorised by target group. A total of 74 reviews were identified dealing with children and adolescents. Each review underwent a quality assessment. Results: 39 reviews with the highest quality and relevance were analysed. 3 reviews focused on the family and home setting, 4 on the childcare setting, 28 on the school setting and 4 on other settings. Evidence revealed the key role played by parents in promoting physical activity in children within each setting. Furthermore, evidence pointed towards the efficacy of multi-component interventions in the childcare and school setting. Several evidence-based intervention strategies were identified for childcare facilities and schools. Discussion: The review of reviews identified a number of promising strategies for PA promotion among children and adolescents. Among reviews, multi-component interventions in childcare facilities and schools stand out prominently. At the same time, the review of reviews indicated that there is still a lack of studies on the efficacy of interventions that go beyond the individual level. We recommend that future research should also target community and policy level interventions and interventions other than the school setting. In order to make more specific recommendations regarding the scale-up of promising intervention strategies, further knowledge about the effectiveness, health equity and cost effectiveness of interventions is needed.

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review of reviews synthesized evidence on physical activity promotion among children and adolescents across family/home, childcare, school, and other settings, analyzing 39 high-quality/relevant reviews from 74 identified. It found parents play a key role and multi-component interventions are effective in childcare and school, while noting gaps in community/policy, non-school, effectiveness, and cost/equity evidence.

Key findings

  • From 213 categorized reviews, 74 addressed children and adolescents; 39 highest-quality/relevant reviews were analyzed: 3 family/home, 4 childcare, 28 school, and 4 other settings.
  • Parental encouragement, support, and role modeling were associated with children’s physical activity and reduced sedentary behavior; parental involvement was important across settings.
  • Multi-component interventions were effective in childcare and school. Childcare strategies included theory/model-based interventions, structured PA, teacher training, more free time, and play equipment; school strategies included increasing and improving PE, teacher training, curriculum PA, activity breaks, after-school programs, environmental changes, active transport, and community/peer involvement.
  • Reported effect estimates included a 24% increase in moderate-to-vigorous PA during PE lessons (Lonsdale et al.), a combined after-school effect size of 0.44 (Beets et al.), a 20 min/day average sedentary-behavior reduction (Van Grieken et al.), and pooled PA effect sizes of 0.14 (Langford et al.) and 0.12 (Kamath et al.).

Methods

  • Systematic review of reviews conducted as part of a German national recommendations project; six electronic databases (PubMed, Scopus, Sport Discus, PsycInfo, ERIC, IBSS) were searched in 2015 for all publication years, with defined inclusion criteria and hand searches.
  • Two independent reviewers screened titles/abstracts and full texts; 213 reviews were categorized by target group, 74 dealt with children/adolescents, and 39 remained after exclusions.
  • Quality was assessed using the AGREE instrument plus a newly developed checklist; a narrative synthesis of the 39 reviews is presented.

Limitations

  • The paper states that evidence is lacking on interventions beyond the individual level, research is dominated by school-setting studies, most reviews assessed efficacy rather than effectiveness, little evidence exists outside family/childcare/school, no evidence was found for the sport club setting, and financing of interventions was not raised in the reviews.
  • The paper states that AGREE criteria are relatively easy to fulfil, so methodologically weak reviews can receive high ratings; an additional instrument was developed to improve quality assessment.
  • Evident from the text: quality assessment is described as performed by “one independent researcher” using AGREE, while later the text says reviews were evaluated independently by two researchers; also, in the school setting the quality rating included 27 of 28 reviews because one was not applicable.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3389/fpubh.2019.00055

Cites

99 of 99 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 136 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    A reduction in parental sedentary screen time can lead to decreased screen time in children.

    “another review found that a reduction in parental (sedentary) screen time can lead to decreased screen time in children (59).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Xu, 2015, Associations of parental influences with physical activity and screen time among young children: a systematic review, J Obes source

      Not checked in the free run.

  • Findingcitation

    Parental behaviour influences the behaviour of their child.

    “Two reviews showed that parental behaviour influences the behaviour of their child.”
    Quote in the paperSubstantial claim
  • Findingcitation

    There is a positive association between children's physical activity levels and the physical activity levels of their parents.

    “While one review identified a positive association between children's PA levels and the PA levels of their parents (58)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Mitchell, 2012, Physical activity in young children: a systematic review of parental influences, Early Child Develop Care. source

      Not checked in the free run.

  • Findingcitation

    Parental encouragement and support can increase physical activity in children.

    “All three reviews stated that parental encouragement and support can increase PA in children (58, 59), as well as reduce sedentary behaviour (57).”
    • Also stated in: § Abstract · plain
      “Evidence revealed the key role played by parents in promoting physical activity in children within each setting.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [58] Mitchell, 2012, Physical activity in young children: a systematic review of parental influences, Early Child Develop Care. source

      Not checked in the free run.

    • cites [59] Xu, 2015, Associations of parental influences with physical activity and screen time among young children: a systematic review, J Obes source

      Not checked in the free run.

  • Findingown data

    Four of the identified reviews dealt with physical activity promotion in childcare facilities.

    “Four of the identified reviews dealt with PA promotion in childcare facilities (Table 4).”
    Quote in the paperNot a substantial claim
  • May combine two claims. 7
  • Classified as probably not a substantial claim. 35
  • The quote only partly states this claim. 2

  • May combine two claims.

    Findingcitation

    Busy work schedules and parent fatigue have negative effects on children's physical activity levels.

    “The availability of PA equipment seemed to have a positive effect on children's PA levels, whereas busy work schedules and parent fatigue demonstrated negative effects (58).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] Mitchell, 2012, Physical activity in young children: a systematic review of parental influences, Early Child Develop Care. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Four reviews were classified as "other" because their results were not connected with one specific setting.

    “Four reviews were classified as “other” as their results were not connected with one specific setting (Table 6).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The level of parental involvement is more important than the setting in which the intervention is conducted.

    “One review concluded that the level of parental involvement is more important than the setting in which the intervention is conducted (57).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [57] Marsh, 2014, Family-based interventions for reducing sedentary time in youth: a systematic review of randomized controlled trials, Obes Rev. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Findingcitation

    Children are most active during the first 10-15 minutes of being outdoors.

    “Additionally, as children are most active during the first 10–15 min of being outdoors, experts suggest the provision of more free time (62).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [62] Ward, 2010, Interventions for increasing physical activity at child care, Med Sci Sports Exerc. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Both experience and personal characteristics played an important role in the promotion of physical activity among children in the childcare setting.

    “Both experience and personal characteristics played an important role in the promotion of PA among children in the childcare setting (61).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Mehtälä, 2014, A socio-ecological approach to physical activity interventions in childcare: a systematic review, Int J Behav Nutr Phys Act. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The use of appropriate behavioural change strategies may be more important than theoretical models.

    “The authors also indicated that the use of appropriate behavioural change strategies may be more important than theoretical models (60).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [60] Ling, 2015, Interventions to increase physical activity in children aged 2-5 years: a systematic review, Pediatr Exerc Sci source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Having well-qualified staff could support skill development and competence in children.

    “Having well-qualified staff could also support skill development and competence in children (13).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Steenbock, 2015, Wie wirksam sind ernährungs- und bewegungsbezogene primärpräventive Interventionen im Setting Kita?, Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Family is the most influential setting for young children.

    “Nevertheless, Mehtälä et al. (61) also stated that family is the most influential setting for young children, and that a partnership between families and childcare is crucial.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Mehtälä, 2014, A socio-ecological approach to physical activity interventions in childcare: a systematic review, Int J Behav Nutr Phys Act. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Findingcitation

    Only one third of non-theory-based interventions were effective.

    “In contrast, only one third of non-theory-based interventions were effective.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingcitation

    Theory or model-based interventions are more successful than non-theory-based interventions.

    “The reviews stated that theory or model-based interventions are more successful.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Findingcitation

    Evidence on parental support in childcare interventions remains unclear.

    “while one review stated that evidence on parental support “remains unclear” (61).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [61] Mehtälä, 2014, A socio-ecological approach to physical activity interventions in childcare: a systematic review, Int J Behav Nutr Phys Act. source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    When play equipment is not provided, children are more prone to sedentary behaviour and engagement in games that promote inactivity.

    “Another way to alter the free play environment at preschool is to provide additional play equipment—when play equipment isn't provided, children are more prone to sedentary behaviour and engagement in games that promote inactivity (62).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [62] Ward, 2010, Interventions for increasing physical activity at child care, Med Sci Sports Exerc. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Findingcitation

    Most theory or model-based interventions show a positive effect.

    “The review by Ling et al. (60) stressed that most theory or model-based interventions show a positive effect.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [60] Ling, 2015, Interventions to increase physical activity in children aged 2-5 years: a systematic review, Pediatr Exerc Sci source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The use of playground markings can increase physical activity in children during recess and lunchtime.

    “One review stated that the use of playground markings can increase PA in children during recess and lunchtime (67), whereas another study found inconclusive evidence (82).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [67] Parrish, 2013, The effect of school recess interventions on physical activity, Sports Med source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Findingcitation

    Evidence on the effect of playground markings on physical activity is inconclusive.

    “One review stated that the use of playground markings can increase PA in children during recess and lunchtime (67), whereas another study found inconclusive evidence (82).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [82] Broekhuizen, 2014, The value of (pre)school playgrounds for children's physical activity level: a systematic review, Int J Behav Nutr Phys Act. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Evidence for parental involvement in school-based interventions was inconclusive due to a lack of studies.

    “Only one review indicated that evidence for parental involvement was inconclusive due to a lack of studies (85).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [85] Van Lippevelde, 2012, Does parental involvement make a difference in school-based nutrition and physical activity interventions? A systematic review of randomized controlled trials, Int J Public Health. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    One review stated that school-based interventions employing a community component were ineffective.

    “Surprisingly, one review stated that school-based interventions employing a community component were ineffective (70).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [70] Salmon, 2007, Promoting physical activity participation among children and adolescents, Epidemiol Rev. source

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingnone given

    Parents play a key role in the family and home setting for physical activity promotion among children and adolescents.

    “Parents play a key role in the family and home setting.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Findingnone given

    Reviews stated that childcare interventions should be theory or model-based, include a PA programme, provide more free time, and contain teacher training.

    “For childcare facilities, reviews stated that interventions should be theory or model-based, include a PA programme, provide more free time, and contain teacher training.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The question of how to finance interventions in the education sector was not even raised in the reviews.

    “The question of how to finance interventions in the education sector was not even raised in the reviews, even though the lack of public funding and resources is perceived as a barrier for childhood obesity prevention by two thirds of stakeholders in Europe (101).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    From the perspective of evidence-based medicine, a systematic review of reviews is the preferred method of knowledge summarisation.

    “From the perspective of evidence-based medicine, the preferred method of knowledge summarisation is through the conduction of a systematic review of reviews (11).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] Smith, 2011, Methodology in conducting a systematic review of systematic reviews of healthcare interventions, BMC Med Res Methodol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two reviewers independently screened full texts from 223 reviews in a secondary screening process.

    “Two reviewers independently screened full texts from 223 reviews in a secondary screening process.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    Evidence from systematic reviews of reviews is needed as the basis for decision making and allows research to have an impact on policy and practice.

    “Such evidence is needed as the basis for decision making and allows research to have an impact on policy and practice (12).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] Brownson, 2009, Bridging the gap: translating research into policy and practice, Prev Med. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Reviews were evaluated independently by two researchers following the methodology proposed by Smith et al.

    “Following the methodology proposed by Smith et al. (11), reviews were evaluated independently by two researchers.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Smith et al. (11) Smith, 2011, Methodology in conducting a systematic review of systematic reviews of healthcare interventions, BMC Med Res Methodol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Titles and abstracts of potentially relevant literature were screened by two independent reviewers.

    “Once the relevant literature had been identified, titles and abstracts were screened by two independent reviewers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Health promotion interventions can be effective in terms of health.

    “Overall, the reviews stated that health promotion interventions can be effective in terms of health (89), obesity prevention (92), and the reduction of socioeconomic inequalities in obesity (91).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [89] Cushing, 2014, Systematic review and meta-analysis of health promotion interventions for children and adolescents using an ecological framework, J Pediatr Psychol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Interventions in the healthcare setting can be effective.

    “One of the reviews stated that interventions in the healthcare setting can be effective (91).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [91] Hillier-Brown, 2014, A systematic review of the effectiveness of individual, community and societal level interventions at reducing socioeconomic inequalities in obesity amongst children, BMC Public Health. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Community and policy level interventions are considered to be more effective in terms of public health than individual level interventions.

    “Research focuses primarily on individual level interventions even though community and policy level interventions are considered to be more effective in terms of public health (61).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [61] Mehtälä, 2014, A socio-ecological approach to physical activity interventions in childcare: a systematic review, Int J Behav Nutr Phys Act. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Computer- and web-based interventions can be effective in promoting physical activity of children and adolescents, especially in schools.

    “This intervention type can be effective, especially with regard to schools (90).”
    • Also stated in: § Research Gaps · plain
      “As other studies show that computer- and web-based interventions can be effective in promoting PA of children and adolescents (90)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [90] Hamel, 2011, Computer- and web-based interventions to increase preadolescent and adolescent physical activity: a systematic review, J Adv Nurs. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    For nations where children only spend half a day in school, school-based interventions might have less relevance for PA promotion.

    “In particular, for nations where children only spend half a day in school (for example, in Germany), school-based interventions might have less relevance for PA promotion.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Schools have neither the capacities nor the facilities for additional interventions for PA promotion.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationcitation

    These findings affect the implementation of the results from this systematic review of reviews into practice.

    “These findings affect the implementation of the results from this systematic review of reviews into practice (e.g., with regard to the number and quality of PE lessons).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In state-centred polity, one can expect more tightly structured institutional sectors.

    “one can expect more tightly structured institutional sectors” (96).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [96] Rowan, 1999, Institutional theory and the study of educational organisations

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    With an increasing number of pupils visiting all-day schools, the need for additional sport facilities, and changes in the school environment might be most relevant.

    “With an increasing number of pupils visiting all-day schools, the need for additional sport facilities, and changes in the school environment might be most relevant.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The percentage of pupils visiting all-day schools has constantly risen over the years (from 9.8% in 2002 up to 39.3% in 2015).

    “However, the percentage of pupils visiting all-day schools has constantly risen over the years (from 9.8% in 2002 up to 39.3% in 2015) (100).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [100] Neue KMK-Statistik für Ganztagsschulen 2015/2016

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In liberal polities, institutional sectors are often organised as complex multi-layered governance systems characterised by fragmented decision-making structures.

    “institutional sectors in liberal polities are often organised as complex multi-layered governance systems characterised by fragmented decision-making structures.””
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [96] Rowan, 1999, Institutional theory and the study of educational organisations

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Hungary, regulation on daily PE classes was implemented as a nation-wide policy in 2012/2013.

    “In Hungary however, regulation on daily PE classes was implemented as a nation-wide policy in 2012/2013 (99).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [99] Netfit2017

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The RE-AIM framework can be used for analysing both efficacy and effectiveness of interventions.

    “Also the RE-AIM framework can be used for analysing both efficacy and effectiveness of interventions, as recent systematic reviews of physical activity interventions for children and youth show (94, 95).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [94] McGoey, 2015, 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 nonrandomized trials, Prev Med. source

      Not checked in the free run.

    • cites [95] McGoey, 2016, 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, Prev Med. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Researchers raise the question whether interventions that are successful in efficacy studies are also effective in the real world.

    “This is problematic as researchers raise the question whether interventions that are successful in efficacy studies are also effective in the real world (56).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [56] Glasgow, 2003, Why don't we see more translation of health promotion research to practice?, Am J Public Health. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The lack of public funding and resources is perceived as a barrier for childhood obesity prevention by two thirds of stakeholders in Europe.

    “The question of how to finance interventions in the education sector was not even raised in the reviews, even though the lack of public funding and resources is perceived as a barrier for childhood obesity prevention by two thirds of stakeholders in Europe (101).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [101] Abu-Omar, 2018, Barriers, facilitators and capacities for childhood obesity prevention in 12 European nations: results of a policy-maker survey, Public Health Panorama. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    Interventions that are most needed might also be connected with overall school policy.

    “Secondly, interventions that are most needed might also be connected with overall school policy.”
    Quote in the paperNot a substantial claim
40 of 40

  • The authors state this as an assumption.

    The AGREE criteria are relatively easy to fulfil, so methodologically weak reviews also receive high ratings.

    “However, as the AGREE criteria are relatively easy to fulfil, methodologically weak reviews also receive high ratings.”

  • The paper relies on this without support.

    The included reviews' findings can be combined narratively across settings to represent the evidence base for children and adolescents.

    “A narrative synthesis of these 39 reviews is presented in this manuscript.”

  • The paper relies on this without support.

    The quality ratings from the AGREE instrument and the newly developed instrument are valid indicators of review quality.

    “Based on the combined results obtained from both instruments, the quality of each review was defined as high, medium or low.”

  • The paper relies on this without support.

    Within the paradigm of evidence-based medicine, knowledge is generated through randomised and controlled trials.

    “Within the paradigm of evidence-based medicine, it is of high importance to generate knowledge through randomised and controlled trials.”

  • The paper relies on this without support.

    In Germany, school lessons usually finish at 1 p.m. or 2 p.m.

    “In Germany, school lessons usually finish at 1 p.m. or 2 p.m.”

  • The paper relies on this without support.

    Schools have neither the capacities nor the facilities for additional interventions for PA promotion.

    “This is because schools have neither the capacities nor the facilities for additional interventions for PA promotion.”
6 of 6

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?

  • 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 [117]

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.

  • A review described as intervention-focused is labeled as having no intervention

    Minor

    The text says all three family-and-home reviews deal specifically with interventions, but Table 3 classifies Mitchell et al. as identifying correlates with no intervention.

1 of 1

Cites

Flagged first, then by citations

4 of the 103 references couldn’t be matched to a known paper.

Research works printed but not linked: 7

  1. Yeh, 2010, Effectiveness of school-based policies to reduce childhood obesity, 193
  2. Wang, 2013, Childhood obesity prevention programs: comparative effectiveness review and meta-analysis
  3. Faulkner, 2010, Economic Policy, Obesity and Health: A Scoping Review
  4. Health promoting schools, interventions and strategies to increase physical activity: review and recommendations4551 BorrasPA J Phys Educ Health Soc Perspect.22012
  5. 2015, What Works in Schools and Colleges to Increase Physical Activity?
  6. Rowan, 1999, Institutional theory and the study of educational organisations, 359
  7. Rütten, 2016, National Recommendations for Physical Activity and Physical Activity Promotion

Cited by

Sorted by citations

Related

Authors
Messing, S., Rütten, A., Abu-Omar, K., Ungerer-Röhrich, U., Goodwin, L., Burlacu, I., & Gediga, G.
Affiliations
  • Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
  • University of Bayreuth (DE)
  • University of Münster (DE)
Corresponding author
Messing, Sven
ORCID
Messing, Sven
Venue
Frontiers in Public Health
Publisher
Frontiers Media SA
Published
2019-03-19
Volume
7
Pages
55-55
ISSN
2296-2565 (ISSN-L)
DOI
10.3389/fpubh.2019.00055
PMC
PMC6433781
OpenAlex
W2924983935
Semantic Scholar
20715b9db47d33e7b7934e2a1aba1fa33254d410
Cited by
259
References
103
Citations by year
2026: 19 · 2025: 28 · 2024: 50 · 2023: 34 · 2022: 61 · 2021: 32 · 2020: 28 · 2019: 6 · 2014: 1
FWCI
3.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Public Health (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • ERef Bayreuth (University of Bayreuth) (submittedVersion)
  • OPUS Repository (Kooperativer Bibliotheksverbund Berlin-Brandenburg) (submittedVersion, cc-by)
Funders
Bundesministerium für Gesundheit (ZMVI 5 2514FSB-200)
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
physical activity promotion, children and adolescents, childhood obesity, school-based intervention, childcare settings, parental role, multicomponent intervention, intervention efficacy, health policy recommendations, physical inactivity

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

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 ›

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