TY - JOUR
T1 - School-based interventions modestly increase physical activity and cardiorespiratory fitness but are least effective for youth who need them most
T2 - an individual participant pooled analysis of 20 controlled trials
AU - Hartwig, Timothy Bryan
AU - Sanders, Taren
AU - Vaconcellos, Diego
AU - Noetel, Michael
AU - Parker, Philip D
AU - Lubans, David Revalds
AU - Andrade, Susana
AU - Ávila-García, Manuel
AU - Bartholomew, John
AU - Belton, Sarahjane
AU - Brooks, Naomi E
AU - Bugge, Anna
AU - Cavero-Redondo, Iván
AU - Christiansen, Lars Breum
AU - Cohen, Kristen
AU - Coppinger, Tara
AU - Dyrstad, Sindre
AU - Errisuriz, Vanessa
AU - Fairclough, Stuart
AU - Gorely, Trish
AU - Javier Huertas-Delgado, Francisco
AU - Issartel, Johann
AU - Kriemler, Susi
AU - Kvalø, Silje Eikanger
AU - Marques-Vidal, Pedro
AU - Martinez-Vizcaino, Vicente
AU - Møller, Niels Christian
AU - Moran, Colin
AU - Morris, John
AU - Nevill, Mary
AU - Ochoa-Avilés, Angélica
AU - O'Leary, Mai
AU - Peralta, Louisa
AU - Pfeiffer, Karin A
AU - Puder, Jardena
AU - Redondo-Tébar, Andrés
AU - Robbins, Lorraine B
AU - Sanchez-Lopez, Mairena
AU - Tarp, Jakob
AU - Taylor, Sarah
AU - Tercedor, Pablo
AU - Toftager, Mette
AU - Villa-González, Emilio
AU - Wedderkopp, Niels
AU - Weston, Kathryn Louise
AU - Yin, Zenong
AU - Zhixiong, Zhou
AU - Lonsdale, Chris
AU - Del Pozo Cruz, Borja
N1 - © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/7
Y1 - 2021/7
N2 - OBJECTIVES: To determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if physical activity intensity mediates improvements in cardiorespiratory fitness.DESIGN: Pooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity.PARTICIPANTS: Data for 6621 children and adolescents aged 4-18 years from 20 trials were included.MAIN OUTCOME MEASURES: Peak oxygen consumption (VO2Peak mL/kg/min) and minutes of moderate and vigorous physical activity.RESULTS: Interventions modestly improved students' cardiorespiratory fitness by 0.47 mL/kg/min (95% CI 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness.CONCLUSIONS: Future interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level.
AB - OBJECTIVES: To determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if physical activity intensity mediates improvements in cardiorespiratory fitness.DESIGN: Pooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity.PARTICIPANTS: Data for 6621 children and adolescents aged 4-18 years from 20 trials were included.MAIN OUTCOME MEASURES: Peak oxygen consumption (VO2Peak mL/kg/min) and minutes of moderate and vigorous physical activity.RESULTS: Interventions modestly improved students' cardiorespiratory fitness by 0.47 mL/kg/min (95% CI 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness.CONCLUSIONS: Future interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level.
U2 - 10.1136/bjsports-2020-102740
DO - 10.1136/bjsports-2020-102740
M3 - Journal article
C2 - 33441332
SN - 0306-3674
VL - 55
SP - 721
EP - 729
JO - British Journal of Sports Medicine
JF - British Journal of Sports Medicine
IS - 13
ER -