Systematic Review and Meta-Analysis of School-Based Multi-Component Physical Activity Interventions

Friday, March 20, 2015: 7:30 AM
213 (Convention Center)
Laura Russ1, Collin A. Webster2, Michael W. Beets2 and David S. Phillips2, (1)Georgia Regents University, Augusta, GA, (2)University of South Carolina, Columbia, SC
Background/Purpose: A “whole-of-school” approach is nationally endorsed to increase youth physical activity (PA). In accordance with this approach, comprehensive school physical activity programs (CSPAP) are recommended. Distinct components of a CSPAP include quality physical education [QPE], PA during the school day [PADSD], PA before/after school [PABAS], staff wellness [SW], and family/community engagement [FCE].  The effectiveness of interventions incorporating multiple CSPAP components is unclear. A systematic review and meta-analysis were conducted examining the effectiveness of multi-component interventions on youth total daily PA.

Method: Electronic databases were searched from August-October 2013 to identify published studies that (1) occurred in the US; (2) targeted K-12; (3) were interventions; (4) reflected ≥2 CSPAP components, with at least one targeting school-based PA during school hours; and (5) reported outcomes as improvements in daily PA.  Data analyses occurred in January 2014.  Standardized mean effects (Hedge’s g) from pooled random effects inverse-variance models were estimated.

Analysis/Results: Across 14 studies, 12 included QPE, 5 PADSD, 1 PABAS, 2 SW, and 14 FCE. No studies included all 5 CSPAP components. The overall impact of interventions was small (0.11, 95CI 0.03 to 0.19). More CSPAP components was related to increased effectiveness with an effect size of 0.06, 0.19, and 0.29 corresponding with 2, 3, and 4 components, respectively. Studies employing objective measures of PA (n=3) resulted in smaller effects (0.02 vs. 0.12) than those using self-report (n=14). Studies including PADSD (0.19 vs. 0.07) and SW (0.21 vs. 0.09) were associated with a larger effect size than interventions not including these components. 

Conclusions: As designed, there is limited evidence of the effectiveness of multi-component interventions to increase youth total daily PA.   Results suggest that taking a multi-component approach to increasing youth PA is an appropriate path, but strategies within and across components may need to be reconsidered for maximal impact.  Future interventions that reflect all five components of the CSPAP model, align with current recommendations, provide detailed descriptions of intervention component design and implementation, and demonstrate dynamic collaboration across all five components are needed.

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