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
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2.
Funding & Partners

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

4.
What is www.healthevidence.org?
Evidence
inform
Decision Making

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
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23.
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