Can schoolyard improvements increase physical activity for the least active students, or just provide better opportunities for the most active?

Introduction School physical activity interventions can improve the physical environment and organizational environment of schools to increase the opportunities for physical activity (PA) in recess. The purpose of this study was to evaluate if improvements to the outdoor physical environment at the school had equal impact on all students regardless of their PA at baseline [1]. Method The SPACE-study used a cluster randomized controlled study design with a 2-year follow-up, and enrolled 1348 students aged 11–13 years from 14 schools in Denmark. A web-based questionnaire was used to obtain knowledge of PA during recess and in leisure time. The multicomponent intervention comprised 11 components, and included a combination of changes to the physical environment and organizational changes. Results At baseline, 73% of the students reported to engage in sport outside school and were characterized as “the most active”. At the intervention schools the proportion of student who reported good possibilities for outdoor PA increased (71% to 75%), while the proportion decreased at the comparison schools (87% to 68%). The proportion of students reporting to be active daily during recess decreased for all groups (87% to 58%). The decrease was smaller at the intervention schools (88% to 62%), but only for the students characterized as the most active at baseline (90% to 66%). Furthermore, there was large variation between intervention schools. Conclusion The intervention produced considerable changes to the environment of all seven intervention schools, and had a positive impact on self-rated PA during recess for the most active students at baseline.