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A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children

Michelle Jones, Emmanuel Defever, Ayland Letsinger, James Steele, Kelly Mackintosh Orcid Logo

Journal of Sport and Health Science

Swansea University Author: Kelly Mackintosh Orcid Logo

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DOI (Published version): 10.1016/j.jshs.2019.06.009

Abstract

PurposeThe aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions at increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5 to 11 years, as well as to explore effectiveness in relation to categories of the theory...

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Published in: Journal of Sport and Health Science
ISSN: 2095-2546
Published: 2019
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URI: https://cronfa.swan.ac.uk/Record/cronfa50136
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2019-10-15T11:34:08.3975805</datestamp><bib-version>v2</bib-version><id>50136</id><entry>2019-04-30</entry><title>A mixed studies systematic review and meta-analysis of school&#x2013;based interventions to promote physical activity and/or reduce sedentary time in children</title><swanseaauthors><author><sid>bdb20e3f31bcccf95c7bc116070c4214</sid><ORCID>0000-0003-0355-6357</ORCID><firstname>Kelly</firstname><surname>Mackintosh</surname><name>Kelly Mackintosh</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2019-04-30</date><deptcode>STSC</deptcode><abstract>PurposeThe aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions at increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5 to 11 years, as well as to explore effectiveness in relation to categories of the theory of expanded, extended and enhanced opportunity (TEO).MethodsAdhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 5 databases were searched using pre-defined search terms. Following title and abstract screening of 1115 records, the removal of duplicates (n&#x202F;=&#x202F;584) and articles that did not meet the inclusion criteria agreed to a priori (n&#x202F;=&#x202F;419) resulted in 112 records that were full-text screened. Two independent reviewers subsequently used the mixed-methods appraisal tool to assess the methodological quality of 57 full-text studies that met the inclusion criteria after full-text screening. The interventions were summarised using the TIDierR checklist and TEO. The strength of evidence was determined using a five-level rating system utilising a published decision tree.ResultsOverall evidence ratings for interventions implemented within school settings were no evidence on moderate-to-vigorous physical activity and inconclusive evidence on sedentary time. In relation to the TEO, expansion of PA appeared to be the most promising intervention type for MVPA, with moderate evidence of effect, whereas extension and enhancement of PA opportunity demonstrated no evidence of effect. A critical issue of possible compensatory behavior was identified by analysis of intervention effect in relation to PA measurement duration; when studies measured changes in PA during the actual intervention there was moderate evidence of effect, whereas those that measured changes in PA during the school day presented inconclusive evidence of effect and those that measured changes in PA over a whole day yielded no evidence of effect. Two meta-analysis of those studies using a whole-day accelerometer measure for MVPA or ST showed a significant but moderate effect for MVPA (effect size (ES)&#x202F;=&#x202F;0.51; 95% Confidence Interval (CI): 0.02&#x2013;0.99) and a large but non-significant effect for ST 1.15 (95%CI: &#x2013;1.03 to 3.33); both meta-analysis demonstrated low precision, considerable inconsistency, and high heterogeneity.ConclusionThe findings have important implications for future intervention research in terms of intervention design, implementation, and evaluation.</abstract><type>Journal Article</type><journal>Journal of Sport and Health Science</journal><publisher/><issnPrint>2095-2546</issnPrint><keywords/><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2019</publishedYear><publishedDate>2019-12-31</publishedDate><doi>10.1016/j.jshs.2019.06.009</doi><url/><notes/><college>COLLEGE NANME</college><department>Sport and Exercise Sciences</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>STSC</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2019-10-15T11:34:08.3975805</lastEdited><Created>2019-04-30T14:17:26.9005066</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences</level></path><authors><author><firstname>Michelle</firstname><surname>Jones</surname><order>1</order></author><author><firstname>Emmanuel</firstname><surname>Defever</surname><order>2</order></author><author><firstname>Ayland</firstname><surname>Letsinger</surname><order>3</order></author><author><firstname>James</firstname><surname>Steele</surname><order>4</order></author><author><firstname>Kelly</firstname><surname>Mackintosh</surname><orcid>0000-0003-0355-6357</orcid><order>5</order></author></authors><documents><document><filename>0050136-30042019141830.pdf</filename><originalFilename>jones2019.pdf</originalFilename><uploaded>2019-04-30T14:18:30.3500000</uploaded><type>Output</type><contentLength>469715</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2019-06-27T00:00:00.0000000</embargoDate><documentNotes>&#xA9; 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2019-10-15T11:34:08.3975805 v2 50136 2019-04-30 A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children bdb20e3f31bcccf95c7bc116070c4214 0000-0003-0355-6357 Kelly Mackintosh Kelly Mackintosh true false 2019-04-30 STSC PurposeThe aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions at increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5 to 11 years, as well as to explore effectiveness in relation to categories of the theory of expanded, extended and enhanced opportunity (TEO).MethodsAdhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 5 databases were searched using pre-defined search terms. Following title and abstract screening of 1115 records, the removal of duplicates (n = 584) and articles that did not meet the inclusion criteria agreed to a priori (n = 419) resulted in 112 records that were full-text screened. Two independent reviewers subsequently used the mixed-methods appraisal tool to assess the methodological quality of 57 full-text studies that met the inclusion criteria after full-text screening. The interventions were summarised using the TIDierR checklist and TEO. The strength of evidence was determined using a five-level rating system utilising a published decision tree.ResultsOverall evidence ratings for interventions implemented within school settings were no evidence on moderate-to-vigorous physical activity and inconclusive evidence on sedentary time. In relation to the TEO, expansion of PA appeared to be the most promising intervention type for MVPA, with moderate evidence of effect, whereas extension and enhancement of PA opportunity demonstrated no evidence of effect. A critical issue of possible compensatory behavior was identified by analysis of intervention effect in relation to PA measurement duration; when studies measured changes in PA during the actual intervention there was moderate evidence of effect, whereas those that measured changes in PA during the school day presented inconclusive evidence of effect and those that measured changes in PA over a whole day yielded no evidence of effect. Two meta-analysis of those studies using a whole-day accelerometer measure for MVPA or ST showed a significant but moderate effect for MVPA (effect size (ES) = 0.51; 95% Confidence Interval (CI): 0.02–0.99) and a large but non-significant effect for ST 1.15 (95%CI: –1.03 to 3.33); both meta-analysis demonstrated low precision, considerable inconsistency, and high heterogeneity.ConclusionThe findings have important implications for future intervention research in terms of intervention design, implementation, and evaluation. Journal Article Journal of Sport and Health Science 2095-2546 31 12 2019 2019-12-31 10.1016/j.jshs.2019.06.009 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2019-10-15T11:34:08.3975805 2019-04-30T14:17:26.9005066 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Michelle Jones 1 Emmanuel Defever 2 Ayland Letsinger 3 James Steele 4 Kelly Mackintosh 0000-0003-0355-6357 5 0050136-30042019141830.pdf jones2019.pdf 2019-04-30T14:18:30.3500000 Output 469715 application/pdf Accepted Manuscript true 2019-06-27T00:00:00.0000000 © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ true eng
title A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children
spellingShingle A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children
Kelly Mackintosh
title_short A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children
title_full A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children
title_fullStr A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children
title_full_unstemmed A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children
title_sort A mixed studies systematic review and meta-analysis of school–based interventions to promote physical activity and/or reduce sedentary time in children
author_id_str_mv bdb20e3f31bcccf95c7bc116070c4214
author_id_fullname_str_mv bdb20e3f31bcccf95c7bc116070c4214_***_Kelly Mackintosh
author Kelly Mackintosh
author2 Michelle Jones
Emmanuel Defever
Ayland Letsinger
James Steele
Kelly Mackintosh
format Journal article
container_title Journal of Sport and Health Science
publishDate 2019
institution Swansea University
issn 2095-2546
doi_str_mv 10.1016/j.jshs.2019.06.009
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences
document_store_str 1
active_str 0
description PurposeThe aim of this mixed-studies systematic review was to ascertain the effectiveness of school-based interventions at increasing physical activity (PA) and/or reducing sedentary time (ST) in children aged 5 to 11 years, as well as to explore effectiveness in relation to categories of the theory of expanded, extended and enhanced opportunity (TEO).MethodsAdhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 5 databases were searched using pre-defined search terms. Following title and abstract screening of 1115 records, the removal of duplicates (n = 584) and articles that did not meet the inclusion criteria agreed to a priori (n = 419) resulted in 112 records that were full-text screened. Two independent reviewers subsequently used the mixed-methods appraisal tool to assess the methodological quality of 57 full-text studies that met the inclusion criteria after full-text screening. The interventions were summarised using the TIDierR checklist and TEO. The strength of evidence was determined using a five-level rating system utilising a published decision tree.ResultsOverall evidence ratings for interventions implemented within school settings were no evidence on moderate-to-vigorous physical activity and inconclusive evidence on sedentary time. In relation to the TEO, expansion of PA appeared to be the most promising intervention type for MVPA, with moderate evidence of effect, whereas extension and enhancement of PA opportunity demonstrated no evidence of effect. A critical issue of possible compensatory behavior was identified by analysis of intervention effect in relation to PA measurement duration; when studies measured changes in PA during the actual intervention there was moderate evidence of effect, whereas those that measured changes in PA during the school day presented inconclusive evidence of effect and those that measured changes in PA over a whole day yielded no evidence of effect. Two meta-analysis of those studies using a whole-day accelerometer measure for MVPA or ST showed a significant but moderate effect for MVPA (effect size (ES) = 0.51; 95% Confidence Interval (CI): 0.02–0.99) and a large but non-significant effect for ST 1.15 (95%CI: –1.03 to 3.33); both meta-analysis demonstrated low precision, considerable inconsistency, and high heterogeneity.ConclusionThe findings have important implications for future intervention research in terms of intervention design, implementation, and evaluation.
published_date 2019-12-31T04:01:28Z
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score 11.035634

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