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Research (CIHR)

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School-based physical
activity programs for children
and adolescents (aged 6 to 18
years): Evidence and
implications for public health
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Source: National Collaborating Centre for Methods and Tools. (revised 2012). A Model for Evidence-Informed DecisionMaking in Public Health. [fact sheet]. Retrieved from http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf
Evidence-Informed Decision Making
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Evidence-Informed Decision Making
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Review
Dobbins, M., Husson, H., DeCorby, K., & LaRocca, R.L.
(2013). School-based physical activity programs for
promoting physical activity and fintess in children and
adolescents aged 6-18. Cochrane Database of
Systematic Reviews,2013(2), Art. No.: CD007651.
Importance of this Review
• Physical inactivity has been identified as the
fourth leading risk factor for global mortality
(WHO)
• 1 in 4 Canadian children and youth are either
overweight or obese (PHAC)
• Schools settings are key for implementation of
interventions that support healthy behaviours
among children
Who has heard of a PICO(S)
question before?
1. Yes
2. No
Searchable Questions – Does it work
Think “PICOS”

1. Population (situation)
2. Intervention (exposure)
3. Comparison (other group)
4. Outcomes
5. Setting
Summary Statement:
Dobbins (2013)
P Children and adolescents aged 6 to 18 years
I Strategies focused on the promotion of physical activity and
fitness including educational, health promotion, counseling,
and management strategies
C Standard, currently existing physical education programs in
schools
O primary outcomes: television viewing, physical activity rates,
and physical activity duration; secondary outcomes: mean
systolic/diastolic blood pressure, mean blood cholesterol
level, body mass index (BMI), maximal Oxygen consumption
(VO2max), and pulse rate
Quality Rating: 10 (strong)
Overall Considerations
This review was based on 44 randomized controlled trials (RCTs),
with the majority of studies at moderate risk of bias.
Intervention duration ranged from 12 weeks to 6 years.
School-based physical activity interventions had positive effects
on the duration of moderate to vigorous physical activity
(MVPA), physical activity rates, television viewing, and
VO2Max.
• No Effect was observed on the following physical health status
measures: blood pressure, cholesterol, BMI, & pulse rate.

Printed education materials plus changes to the school
curriculum were present whenever statistically significant
changes in duration of MVPA, physical activity rates, television
viewing rates and V02Max were observed.
What’s the evidence -

Outcomes reported in the review
Behavioural Outcomes(5 studies assessed physical activity

rates; 23 studies assessed duration of physical activity; and 17
studies assessed time spent watching television )

Physical Health Status Related Outcomes (16 studies

assessed mean systolic blood pressure; 16 studies assessed
mean diastolic blood pressure; 10 studies assessed mean blood
cholesterol level; 32 studies assessed Body Mass Index (BMI); 6
studies assessed maximal Oxygen consumption (VO2max); and 6
studies assessed pulse rate)
What’s the evidence -

Behavioural Outcome: Physical
Activity Rates
Physical Activity Rates (5 studies)
• 2 of 5 studies, OR 2.74 (CI: 2.01-3.75), led to statistically
significant increase in physical activity rates among grade school
children.
• Intervention components included: school curriculum changes,
printed educational materials, community-based strategies,
audio-visual materials, and play equipment.
What’s the evidence -

Behavioural Outcome: Duration of
Physical Activity
Duration of Physical Activity (23 Studies)
• 12 of 17 studies led to statistically significant increases in
physical activity duration among grade school children
(increases in duration ranged from approx. 5 min to 45 minutes
more per week of MVPA, with CIs ranging from 1.4 min to
approx. 90 min more per week of MVPA)
•

Intervention components consistent across studies included:
changes to school curricula and printed educational materials.
What’s the evidence -

Behavioural Outcome: Time Spent
Watching Television
Time Spent Watching Television (17 studies)
• 7 of 16 studies reported statistically significant effects on
television viewing (reduction in television viewing ranged from 5
min less per day to 60 min less per day).
• Intervention components consistent across studies included:
changes to curricula, printed education materials, education
sessions, and community-based strategies
What’s the evidence -

Physical Health Status Related
Outcomes
Maximal Oxygen Consumption (VO2max) (6 studies)
• 4 of 6 studies reported statistically significant effects on VO2max
(ranging from 1.6 to 3.7mL/kg per min; 95% CI: 0.2 to 7.2 mL/kg
per min) among grade school children.
No Impact observed on: blood pressure, cholesterol, body mass
index, and pulse rate.
General Implications
School-based interventions should be implemented, supported
and/or advocated for by the public health sector as a means to
increase duration of MVPA, increase physical activity rates,
improve V02Max, and reduce television viewing among children.
At a minimum, school based interventions should include printed
educational materials and curriculum changes that promote
increased MVPA during school hours. Combining additional
intervention components such as educational sessions, physical
activity specific sessions and community-based initiatives, may
have added benefit but requires further evaluation.
Interventions should be implemented for a minimum of 12 weeks.
Impact in the long term requires additional evaluation.
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School-based physical activity programs for children and adolescents (aged 6 to 18 years): Evidence and implications for public health

  • 1. This work received support from KT Canada funding from the Canadian Institutes of Health Research (CIHR) Welcome! School-based physical activity programs for children and adolescents (aged 6 to 18 years): Evidence and implications for public health You will be placed on hold until the webinar begins. The webinar will begin shortly, please remain on the line.
  • 3. The Health Evidence Team Kara DeCorby Managing Director Heather Husson Project Manager Robyn Traynor Research Coordinator Lori Greco Knowledge Broker Stephanie Workentine Research Assistant Maureen Dobbins Scientific Director Matt Edmonds Research Assistant Tel: 905 525-9140 ext 22481 E-mail: dobbinsm@mcmaster.ca Yaso Gowrinathan Research Assistant/ Coordinator Kelly Graham Research Assistant
  • 5. Why use www.healthevidence.org? 1. Saves you time 2. Relevant & current evidence 3. Transparent process 4. Supports for EIDM available 5. Easy to use
  • 6. A Model for Evidence-Informed Decision Making Source: National Collaborating Centre for Methods and Tools. (revised 2012). A Model for Evidence-Informed DecisionMaking in Public Health. [fact sheet]. Retrieved from http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf
  • 7. Evidence-Informed Decision Making 1. Cultivate a culture of inquiry, critical thinking and evidence-based practice “culture” 2. Ask a clear, focused, searchable question 3. Search for the best available evidence 4. Critically appraise the relevant evidence
  • 8. Evidence-Informed Decision Making 5. Integrate the evidence with expertise and client preference 6. Evaluate the outcome(s) of the change in practice or policy 7. Engage in knowledge exchange
  • 9. Review Dobbins, M., Husson, H., DeCorby, K., & LaRocca, R.L. (2013). School-based physical activity programs for promoting physical activity and fintess in children and adolescents aged 6-18. Cochrane Database of Systematic Reviews,2013(2), Art. No.: CD007651.
  • 10. Importance of this Review • Physical inactivity has been identified as the fourth leading risk factor for global mortality (WHO) • 1 in 4 Canadian children and youth are either overweight or obese (PHAC) • Schools settings are key for implementation of interventions that support healthy behaviours among children
  • 11. Who has heard of a PICO(S) question before? 1. Yes 2. No
  • 12. Searchable Questions – Does it work Think “PICOS” 1. Population (situation) 2. Intervention (exposure) 3. Comparison (other group) 4. Outcomes 5. Setting
  • 13. Summary Statement: Dobbins (2013) P Children and adolescents aged 6 to 18 years I Strategies focused on the promotion of physical activity and fitness including educational, health promotion, counseling, and management strategies C Standard, currently existing physical education programs in schools O primary outcomes: television viewing, physical activity rates, and physical activity duration; secondary outcomes: mean systolic/diastolic blood pressure, mean blood cholesterol level, body mass index (BMI), maximal Oxygen consumption (VO2max), and pulse rate Quality Rating: 10 (strong)
  • 14. Overall Considerations This review was based on 44 randomized controlled trials (RCTs), with the majority of studies at moderate risk of bias. Intervention duration ranged from 12 weeks to 6 years. School-based physical activity interventions had positive effects on the duration of moderate to vigorous physical activity (MVPA), physical activity rates, television viewing, and VO2Max. • No Effect was observed on the following physical health status measures: blood pressure, cholesterol, BMI, & pulse rate. Printed education materials plus changes to the school curriculum were present whenever statistically significant changes in duration of MVPA, physical activity rates, television viewing rates and V02Max were observed.
  • 15. What’s the evidence - Outcomes reported in the review Behavioural Outcomes(5 studies assessed physical activity rates; 23 studies assessed duration of physical activity; and 17 studies assessed time spent watching television ) Physical Health Status Related Outcomes (16 studies assessed mean systolic blood pressure; 16 studies assessed mean diastolic blood pressure; 10 studies assessed mean blood cholesterol level; 32 studies assessed Body Mass Index (BMI); 6 studies assessed maximal Oxygen consumption (VO2max); and 6 studies assessed pulse rate)
  • 16. What’s the evidence - Behavioural Outcome: Physical Activity Rates Physical Activity Rates (5 studies) • 2 of 5 studies, OR 2.74 (CI: 2.01-3.75), led to statistically significant increase in physical activity rates among grade school children. • Intervention components included: school curriculum changes, printed educational materials, community-based strategies, audio-visual materials, and play equipment.
  • 17. What’s the evidence - Behavioural Outcome: Duration of Physical Activity Duration of Physical Activity (23 Studies) • 12 of 17 studies led to statistically significant increases in physical activity duration among grade school children (increases in duration ranged from approx. 5 min to 45 minutes more per week of MVPA, with CIs ranging from 1.4 min to approx. 90 min more per week of MVPA) • Intervention components consistent across studies included: changes to school curricula and printed educational materials.
  • 18. What’s the evidence - Behavioural Outcome: Time Spent Watching Television Time Spent Watching Television (17 studies) • 7 of 16 studies reported statistically significant effects on television viewing (reduction in television viewing ranged from 5 min less per day to 60 min less per day). • Intervention components consistent across studies included: changes to curricula, printed education materials, education sessions, and community-based strategies
  • 19. What’s the evidence - Physical Health Status Related Outcomes Maximal Oxygen Consumption (VO2max) (6 studies) • 4 of 6 studies reported statistically significant effects on VO2max (ranging from 1.6 to 3.7mL/kg per min; 95% CI: 0.2 to 7.2 mL/kg per min) among grade school children. No Impact observed on: blood pressure, cholesterol, body mass index, and pulse rate.
  • 20. General Implications School-based interventions should be implemented, supported and/or advocated for by the public health sector as a means to increase duration of MVPA, increase physical activity rates, improve V02Max, and reduce television viewing among children. At a minimum, school based interventions should include printed educational materials and curriculum changes that promote increased MVPA during school hours. Combining additional intervention components such as educational sessions, physical activity specific sessions and community-based initiatives, may have added benefit but requires further evaluation. Interventions should be implemented for a minimum of 12 weeks. Impact in the long term requires additional evaluation.
  • 21. Poll Question Did you find the information presented today helpful? Yes No
  • 22. Poll Question Was this information new to you? Yes No
  • 24. Contact Us info@healthevidence.org For a copy of the presentation please visit our posting board: http://forum.healthevidence.org/ Login with your healthevidence username and password or register if you aren’t a member yet.

Editor's Notes

  1. Polls 1, 2 and 3: (open-ended questions, posed prior to webinar beginning)   What has been your experience in finding/using evidence related to school-based physical activity programs for children and adolescents?   How do you use research evidence to inform your practice? Where are you from?
  2. This work received support from KT Canada funding from the Canadian Institutes of Health Research (CIHR)
  3. Poll question #4
  4. Poll 4: Had you heard of PICO before today’s webinar? Yes No
  5. FINAL Polls 5 and 6: Did you find the information presented today helpful? Yes No   Was this information new to you? Yes No