Effectiveness of the ‘Girls Active’ school-based physical activity programme: A cluster randomised controlled trial Effects of a playground marking intervention on school recess physical activity in French children. A Longitudinal Study of the Family Physical Activity Environment and Physical Activity among Youth Objectively measured physical activity in four-year-old British children: a cross-sectional analysis of activity patterns segmented across the day Increasing physical activity among young children from disadvantaged communities: study protocol of a group randomised controlled effectiveness trial A school-based physical activity program to improve health and fitness in children aged 6–13 years ("Kinder-Sportstudie KISS"): study design of a randomized controlled trial [ISRCTN15360785] Using step cadence goals to increase moderate-to-vigorous-intensity physical activity. Intrapersonal, social and physical environmental determinants of moderate-to-vigorous physical activity in working-age women: a systematic review protocol Preliminary findings of the effect of a 3-year after-school physical activity intervention on fitness and body fat: the Medical College of Georgia Fitkid Project. Accelerometer-measured sedentary time and physical activity-A 15 year follow-up of mortality in a Swedish population-based cohort. The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review A comprehensive physical activity promotion programme at elementary school: the effects on physical activity, physical fitness and psychosocial correlates of physical activity. Rationale and study protocol for the supporting children’s outcomes using rewards, exercise and skills (SCORES) group randomized controlled trial: A physical activity and fundamental movement skills intervention for primary schools in low-income communities Design of a 20-month comprehensive, multicomponent school-based randomised trial to promote healthy weight development among 11-13 year olds: The HEalth In Adolescents study Sustained effects of physical activity on bone health: Iowa Bone Development Study. Moderate to Vigorous Physical Activity and Weight Outcomes: Does Every Minute Count? An intervention to reduce sitting and increase light-intensity physical activity at work: Design and rationale of the 'Stand & Move at Work' group randomized trial. An overview of "The Active by Choice Today" (ACT) trial for increasing physical activity. MVPA Is Associated with Lower Weight Gain in 8–10 Year Old Children: A Prospective Study with 1 Year Follow-Up A behaviour change intervention to reduce sedentary time in people with chronic obstructive pulmonary disease: protocol for a randomised controlled trial. Definition, measurement, and health risks associated with sedentary behavior. Home-based physical activity intervention for breast cancer patients. Weekend and weekday patterns of physical activity in overweight and normal-weight adolescent girls. Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines Physical activity and skills intervention: SCORES cluster randomized controlled trial. A 10-Month Physical Activity Intervention Improves Body Composition in Young Black Boys The relative influence of demographic, individual, social, and environmental factors on physical activity among boys and girls Remote and web 2.0 interventions for promoting physical activity. Physical activity, diet and BMI in children aged 6–8 years: a cross-sectional analysis What helps children to move more at school recess and lunchtime? Mid-intervention results from Transform-Us! cluster-randomised controlled trial Mediators of Physical Activity Behavior Change in the “Girls on the Move” Intervention Assessment of a two-year school-based physical activity intervention among 7-9-year-old children The relationship between psychosocial correlates and physical activity in underserved adolescent boys and girls in the ACT trial.
Background Globally , adolescent girls ’  physical activity ( PA ) levels are low . The ‘ Girls Active ’ secondary school-based programme , developed by the Youth Sport Trust , aims to increase PA in adolescent girls . This paper explores the effectiveness of the ‘ Girls Active ’ school-based PA programme . Methods A r and om sample of girls aged 11–14 from 20 secondary schools ( Midl and s , UK ) participated in a two-arm cluster r and omised controlled trial . Ten schools received Girls Active and 10 continued with usual practice . Measurements were taken at baseline , seven- and 14-month follow-up . Primary outcome : wrist-worn accelerometer measured moderate- to vigorous-intensity PA ( MVPA ) .  Secondary outcomes : overall PA , light PA , sedentary time , body composition , and psychosocial outcomes . Generalised estimating equations , adjusted for school cluster and potential confounders , were used and A priori subgroup analysis was undertaken . Micro-costing and cost-consequence analyses were conducted using bespoke collection methods on programme delivery information . Outcomes for the cost-consequence analysis were health related quality of life measured by the Child Health Utility-9D and service use . Results Overall , 1752 pupils participated , 1211 ( 69.1 % ) provided valid 14-month accelerometer data . No difference in MVPA ( mins/day ; 95 % confidence intervals ) was found at 14 months ( 1.7 ; -0.8 to 4.3 ) , there was at seven months ( 2.4 ; 0.1 to 4.7 ) . Subgroup analyses showed significant intervention effects on 14-month in larger schools ( 3.9 ; 1.39 to 6.09 ) and in White Europeans ( 3.1 ; 0.60 to 6.02 ) and in early maturers ( 5.1 ; 1.69 to 8.48 ) at seven months . The control group did better in smaller schools at 14-months ( -4.38 ; -7.34 to -1.41 ) . Significant group differences were found in 14-month identified motivation ( -0.09 ; -0.18 to -0.01 ) and at seven months in : overall PA ( 1.39 mg/day ; 0.1 to 2.2 ) , after-school sedentary time ( -4.7 ; -8.9 to -0.6 ) , whole day ( 5.7 ; 1.0 to 10.5 ) and school day ( 4.5 ; 0.25 to 8.75 ) light PA , self-esteem . Small , statistically significant , differences in some psychosocial variables favoured control schools . Micro-costing demonstrated that delivering the programme result ed in a range of time and financial costs at each school . Cost-consequence analysis demonstrated no effect of the programme for health related quality of life or service use . Conclusions Compared with usual practice , ‘ Girls Active ’ did not affect 14-month MVPA.Trial registration IS RCT OBJECTIVE Playground interventions offer an opportunity to enhance school recess physical activity . We aim ed to assess the effects of playground marking on objective ly measured school recess physical activity in French children . METHODS Participants were four hundred and twenty children ( 6 - 11years old ) from 4 primary schools in Nord-Pas de Calais , France . Children 's physical activity ( PA ) was measured with a uniaxial accelerometer twice a day ( morning and afternoon recess ) during a 4-day school week in April and May 2009 . Two experimental schools ( EG ) received a recess-based intervention ( playground markings ) and two others served as controls ( CG ) . Percentage of time spent on the following intensities of physical activity during school recess was measured before and after intervention : sedentary ( SED ) , light physical activity ( LPA ) , moderate physical activity ( MPA ) , vigorous physical activity ( VPA ) , very high physical activity ( VHPA ) and moderate-to-vigorous physical activity ( MVPA ) . RESULTS At baseline , school recess PA among children from CG was significantly ( p<0.001 ) higher than that among EG children . No interaction was observed between the recess-based intervention and gender . After the intervention , the EG spent significantly ( p<0.05 ) more time in MPA , VPA and MVPA with a concomitant significant decrease in SED ( p<0.05 ) compared to baseline , while the PA in CG remained unchanged . CONCLUSION Painted playground markings had a positive short-term effect on school recess physical activity levels Purpose . Although the family environment is a potentially important influence on children 's  physical activity ( PA )  , prospect i ve data investigating these associations are lacking . This study aim ed to examine the longitudinal relationship between the family environment and PA among youth . Design . A 5-year prospect i ve cohort study . Setting . Nineteen r and omly selected public schools in Melbourne , Australia . Subjects . Families of 5- to 6-year-old ( n = 190 ) and 10- to 12-year-old ( n = 350 ) children . Measures . In 2001 , parents reported their participation in PA , family-based PA , and support and reinforcement for their child 's PA . In 2001 , 2004 , and 2006 ,  moderate to vigorous intensity PA ( MVPA )  was assessed among youth using accelerometers .  Weekend and “ critical window ” ( after school until 6:00 P.M. ) MVPA were examined because we hypothesized that the family environment would most likely influence these behaviors . Analysis . Generalized estimating equations predicted average change in MVPA over 5 years from baseline family environment factors . Results . Maternal role modeling was positively associated with boys ' critical window and weekend ( younger boys ) MVPA .  Paternal reinforcement of PA  was positively associated with critical window and weekend MVPA among all boys , and paternal direct support was positively associated with weekend MVPA ( older boys ) . Among girls , maternal coparticipation in PA predicted critical window MVPA , and sibling coparticipation in PA was directly associated with weekend MVPA ( younger girls ) . Conclusions . Longitudinal relationships , although weak in magnitude , were observed between the family environment and MVPA among youth . Interventions promoting maternal role modeling , paternal reinforcement of and support for PA , and maternal and sibling coparticipation in PA with youth are warranted . ( Am J Health Promot 2011;25[3]:159–167 . Background Little is known about preschool-aged children ’s levels of  physical activity ( PA ) over the course of the day . Using time-stamped data , we describe the levels and patterns of PA in a population -based sample of four-year-old British children . Methods Within the Southampton Women ’s Survey the PA levels of 593 4-year-old children ( 51 % female ) were measured using ( Actiheart ) accelerometry for up to 7 days . Three outcome measures : minutes spent sedentary ( < 20 cpm ) ; in light ( LPA : ≥20 – 399 cpm ) and in moderate-to-vigorous activity ( MVPA : ≥400 cpm ) were derived . Average daily activity levels were calculated and then segmented across the day ( morning , afternoon and evening ) . MVPA was log-transformed . Two-level r and om intercept models were used to analyse associations between activity level and temporal and demographic factors . Results Children were active for 67 % ( mean 568.5 SD 79.5 minutes ) of their daily registered time on average , with 88 % of active time spent in LPA . All children met current UK guidelines of 180 minutes of daily activity . There were no differences in children ’s average daily levels of sedentary activity and LPA by temporal and demographic factors : differences did emerge when activity was segmented across the day . Sex differences were largest in the morning , with girls being more sedentary , spending fewer minutes in LPA and 18 % less time in MVPA than boys . Children were more sedentary and less active ( LPA and MVPA ) in the morning if they attended childcare full-time compared to part-time , and on weekend mornings compared to weekdays . The reverse was true for weekend afternoons and evenings . Children with more educated mothers were less active in the evenings . Children were less sedentary and did more MVPA on summer evenings compared to winter evenings . Conclusions Preschool-aged children meet current physical activity guidelines , but with the majority of their active time spent in LPA , investigation of the importance of activity intensity in younger children is needed . Activity levels over the day differed by demographic and temporal factors , highlighting the need to consider temporality in future interventions . Increasing girls ’ morning activity and providing opportunities for daytime activity in winter months may be worthwhile Background Participation in regular physical activity ( PA ) during the early years helps children achieve healthy body weight and can substantially improve motor development , bone health , psychosocial health and cognitive development . Despite common assumptions that young children are naturally active , evidence shows that they are insufficiently active for health and developmental benefits . Exploring strategies to increase physical activity in young children is a public health and research priority . Methods Jump Start is a multi-component , multi- setting PA and gross motor skill intervention for young children aged 3–5 years in disadvantaged areas of New South Wales , Australia . The intervention will be evaluated using a two-arm , parallel group , r and omised cluster trial . The Jump Start protocol was based on Social Cognitive Theory and includes five components : a structured gross motor skill lesson ( Jump In ) ; unstructured outdoor PA and gross motor skill time ( Jump Out ) ; energy breaks ( Jump Up ) ; activities connecting movement to learning experiences ( Jump Through ) ; and a home-based family component to promote PA and gross motor skill ( Jump Home ) . Early childhood education and care centres will be demographically matched and r and omised to Jump Start ( intervention ) or usual practice ( comparison ) group . The intervention group receive Jump Start professional development , program re sources , monthly newsletters and ongoing intervention support . Outcomes include change in total PA ( accelerometers ) within centre hours , gross motor skill development ( Test of Gross Motor Development-2 ) , weight status ( body mass index ) , bone strength ( Sunlight MiniOmni Ultrasound Bone Sonometer ) , self-regulation ( Heads-Toes-Knees-Shoulders , executive function tasks , and proxy-report Temperament and Approaches to learning scales ) , and educator and parent self-efficacy . Extensive quantitative and qualitative process evaluation and a cost-effectiveness evaluation will be conducted . Discussion The Jump Start intervention is a unique program to address low levels of PA and gross motor skill proficiency , and support healthy lifestyle behaviours among young children in disadvantaged communities . If shown to be efficacious , the Jump Start approach can be expected to have implication s for early childhood education and care policies and practice s , and ultimately a positive effect on the health and development across the life course . Trial registration Australian and New Zeal and Clinical Trials Registry No : ACTRN12614000597695 , first received : June 5 , 2014 Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure . A major contributing factor is physical inactivity which is closely linked to bone health , cardiovascular disease risk , fitness and psychological factors . The school seems to provide an excellent setting to enhance levels of  physical activity ( PA ) .  However , there is insufficient data from previous school-based intervention trials on how to enhance overall PA . It is also unknown whether an intervention aim ed at increasing PA is effective in improving the children 's health . The purpose of this paper is to outline the design of a school-based r and omized , controlled trial ( RCT ) aim ing to increase overall PA and to improve fitness and health in 6- to 13-year-old children . Methods / Design 15 schools were r and omized to the intervention ( n = 9 ) or the control ( n = 6 ) group , stratified by geographic region ( urban vs. rural ) and by age ( 1st and 5th grade ) . Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum . The intervention during one academic year consisted of : 1 . two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week , 2 . short PA breaks ( 2–5 min each ) during academic lessons , 3 . PA home work , and 4 . adaptation of recreational areas around the school . All children underwent  anthropometric measurements , blood pressure assessment , fitness testing , measurement of PA  and they filled out question naires . At least 70 % of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry . The primary endpoints of the study after one year were an increase in total PA by accelerometry , an increase in aerobic fitness measured by the 20 m shuttle run , a decrease in percent body fat derived from skinfold measurements and an increase in quality of life as assessed by the child health question naire in the intervention group compared to the control group . Secondary outcomes were overall fitness , differences in body composition including body fat distribution , cardiovascular risk factors , psychosocial health , bone mineral content and density of femur , lumbar spine and total body and food intake . Discussion Our preliminary data suggest that the children were representative of Swiss children with respect to sex , socio-demographic status , and body mass index . Short-term results can be expected by the beginning of 2007 . We hypothesized that our intervention will lead to an increase in PA , fitness and overall health . Based on our data , we aim to provide important information regarding the influence of such an intervention on these outcome measures in school-aged children and to provide nationwide guidelines to improve PA in children BACKGROUND Increasing moderate-to-vigorous-intensity physical activity ( MVPA ) is an important public health goal . Pedometers are evidence -based devices for increasing daily activity , but studies have not evaluated the comparative efficacy of step cadence goals for increasing MVPA . PURPOSE This study aim ed to evaluate the efficacy of three pedometer-based step goals for increasing MVPA . METHODS Latina women ( n = 180 ; 18 - 55 yr , mean body mass index = 31.1 , SD = 6.5 ) were recruited to 12 community centers , which were r and omly assigned to one of three conditions . Each group received an identical 12-wk theory-based physical activity ( PA ) intervention that differed only on the type of daily step goal : 1 ) a self-selected goal ( SELF ) ; 2 ) a goal of 10,000 steps per day ( FREQUENCY ) ; or 3 ) a goal of 3000 steps in 30 min ( CADENCE ) . Accelerometer-based PA  was measured at baseline and after 12 wk . RESULTS Adjusted multilevel pattern-mixture models using generalized estimating equations revealed that participants in the CADENCE condition engaged in similar levels of postintervention MVPA to those in the SELF and FREQUENCY goal conditions . However , MVPA of participants in the CADENCE condition was more likely to occur in bouts lasting greater than 10 consecutive minutes compared with the MVPA of participants in the SELF ( P = 0.01 ) or FREQUENCY ( P = 0001 ) conditions . CONCLUSIONS PA interventions should consider including a step cadence goal to help individuals accumulate bout-based MVPA and meet national PA guidelines Background The majority of North American adult females do not meet current physical activity recommendations ( 150 min of moderate-to-vigorous intensity physical activity ( MVPA ) per week accrued in ≥10 min bouts ) ultimately placing themselves at increased risk of morbidity and mortality . Working-age females face particular challenges in meeting physical activity recommendations as they have multiple dem and s , including occupational , family and social dem and s. To develop effective interventions to increase MVPA among working-age females , it is necessary to identify and underst and the strongest modifiable determinants influencing these behaviours . Therefore , the objective of this systematic review is to examine the available evidence to identify intrapersonal , social and environmental determinants of MVPA among working-age females . Methods / Design Six electronic data bases will be search ed to identify all prospect i ve cohort studies that report on intrapersonal , social and /or environmental determinants of  MVPA  in working-age females . Grey literature sources including theses , published conference abstract s and websites from relevant organizations will also be included . Articles that report on intrapersonal ( e.g. health status , self-efficacy , socio-economic status ( SES ) , stress , depression ) , social environmental ( e.g. crime , safety , area SES , social support , climate and capital , policies ) , and environmental ( e.g. weather , workplace , home , neighbourhood , recreation environment , active transportation ) determinants of MVPA  in a working-age ( mean age 18–65 years ) female population will be included . Risk of bias will be assessed within and across all included studies using the Tool to Assess Risk of Bias in Cohort Studies and the Grade s of Recommendation , Assessment , Development and Evaluation approach . Harvest plots will be used to synthesize results across all determinants , and meta-analyses will be conducted where possible among studies with sufficient homogeneity . Discussion This review will provide a comprehensive examination of evidence in this field and will serve to highlight gaps for future research on the determinants of MVPA in working-age females and ultimately inform intervention design . Systematic review registration PROSPERO : CRD42014009750 OBJECTIVE To evaluate the effect of a 3-year after-school physical activity ( PA ) intervention on aerobic fitness and percent body fat ( % BF ) . METHODS In total , 18 schools were r and omized into intervention or control arms . Measurements were made at the beginning and end of the third , fourth and fifth grade s. Fitness was measured with heart rate response to a bench-stepping task.%BF and bone density were measured with dual-energy x-ray absorptiometry . The intervention included 40 min of academic enrichment activities , during which healthy snacks were provided , and 80 min of moderate-to-vigorous PA ( MVPA ) . RESULTS Data analyses were performed on 206 youths who remained in the same schools for the 3-year period , who were measured at all six time points and , for the intervention group , who attended at least 40 % of the sessions in each of the 3 years . The group by time interactions were significant for fitness ( p < 0.01 ) and % BF ( p < 0.05 ) . Children in intervention schools improved in fitness and % BF during the school years and returned to levels similar to those in control schools during the summers . Over the six measurement points , the intervention group increased more than the control group in bone density ( p < 0.01 ) , fat-free soft tissue ( p < 0.01 ) , weight ( p < 0.01 ) , height ( p < 0.01 ) , and body mass index ( p < 0.05 ) . CONCLUSIONS An after-school program focusing on MVPA had a beneficial effect on fitness and body composition . During the summers , the beneficial effect of the previous year 's participation on fitness and % BF was lost . This highlights the importance of year-round programs to promote healthy growth in youths OBJECTIVES To investigate the associations of objective ly assessed sedentary time , light intensity physical activity ( PA ) , moderate to vigorous intensity PA ( MVPA ) , and total PA with all-cause mortality and mortality from cardiovascular disease ( CVD ) or cancer in a Swedish population -based cohort with 15 years follow-up time . DESIGN Longitudinal prospect i ve cohort study . METHODS Data from 851 persons ( 56 % women ) ≥35 years at baseline were included . Primary exposure variables were  time ( min/day ) spent sedentary , in light intensity PA and in MVPA , and total counts from an Actigraph 7164 accelerometer . Data on all-cause mortality and mortality from CVD or cancer were obtained from Swedish registers . Cox proportional hazards models estimated hazard ratios ( HR ) of mortality with 95 % confidence intervals ( CI ) . RESULTS Compared with the least sedentary participants , those in the most sedentary tertile had an increased risk of all-cause mortality , HR : 2.7 ( 1.4 , 5.3 ) , CVD mortality , HR : 5.5 ( 1.4 , 21.2 ) and cancer mortality , HR : 4.3 ( 1.2 , 16.0 ) . For all-cause mortality , those in the highest light intensity PA tertile had a HR 0.34 ( 0.17 , 0.67 ) compared with the lowest tertile . A similar pattern was found for CVD and cancer mortality . More time spent in MVPA was associated with the largest risk reduction for CVD mortality , with an almost 90 % lower risk in the tertile with the most time in MVPA . CONCLUSIONS This study confirms a strong inverse relationship between MVPA and mortality , and adds new insight for the underst and ing of the associations between sedentary time  and light intensity PA  and mortality Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population OBJECTIVE To evaluate the effects of a comprehensive physical activity ( PA ) promotion programme in elementary schools on children 's total PA levels , leisure-time PA , physical fitness and psychosocial correlates of PA . DESIGN A pre-test-post-test design over two school years . SETTING AND SUBJECTS Sixteen elementary schools ( 764 children , mean age : 11.2 + /- 0.7 years ) were r and omly assigned to the intervention condition ( n = 8) and the control condition ( n = 8) . The intervention included a health-related physical education programme , an extracurricular PA promotion programme and classroom-based PA education lessons . In the total sample , leisure-time PA , psychosocial correlates of PA and physical fitness were measured using a PA question naire and the Eurofit test battery . In a sub- sample , total PA levels were measured using an accelerometer . RESULTS According to accelerometer data , children 's moderate PA and moderate-to-vigorous PA ( MVPA ) levels decreased less in the intervention schools than in the control schools ( P < 0.01 ) . The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools . Children in the intervention schools reported significantly more moderate PA in leisure time than the controls ( P < 0.05 ) . No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found . CONCLUSIONS The comprehensive PA promotion programme was successful in preventing a decline in children 's  total activity levels . Furthermore , the intervention increased children 's PA engagement in leisure time . Therefore , implementation needs to be encouraged Background Many Australian children are insufficiently active to accrue health benefits and physical activity ( PA ) levels are consistently lower among youth of low socio-economic position .  PA levels decline dramatically during adolescence and evidence suggests that competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against this trend . Methods / design The Supporting Children ’s Outcomes Using Rewards Exercise and Skills ( SCORES ) intervention is a multi-component PA and FMS intervention for primary schools in low-income communities , which will be evaluated using a group r and omized controlled trial . The socio-ecological model provided a framework for the 12-month intervention , which includes the following components : teacher professional learning , student leadership workshops ( including leadership accreditation and rewards , e.g. , stickers , water bottles ) , PA policy review , PA equipment packs , parental engagement via newsletters , FMS homework and a parent evening , and community partnerships with local sporting organizations . Outcomes will be assessed at baseline , 6- and 12-months . The primary outcomes are PA ( accelerometers ) , FMS ( Test of Gross Motor Development II ) and cardiorespiratory fitness ( multi-stage fitness test ) . Secondary outcomes include body mass index [ using weight (kg)/height ( m2 ) ] , perceived competence , physical self-esteem , and resilience . Individual and environmental mediators of behavior change ( e.g. social support and enjoyment ) will also be assessed . The System for Observing Fitness Instruction Time will be used to assess the impact of the intervention on PA within physical education lessons . Statistical analyses will follow intention-to-treat principles and hypothesized mediators of PA behavior change will be explored . Discussion SCORES is an innovative primary school-based PA and FMS intervention design ed to support students attending schools in low-income communities to be more skilled and active . The findings from the study may be used to guide teacher pre-service education , professional learning and school policy in primary schools . Trial registration Australian New Zeal and Clinical Trials Registry No : Background and purpose : The lack of effective school-based interventions for preventing obesity in children has caused a call for longer duration of interventions and better reporting on design and evaluation methodology . The purpose of this paper is to present the development of the intervention , the design of the effectiveness study , and the test-retest reliability of the main outcome measures in the HEalth In Adolescents ( HEIA ) study . Methods / design : The HEIA intervention programme was developed based on literature review s , a social ecological framework , and focus groups . The intervention aim ed to increase total physical activity ( PA ) and consumption of fruit and vegetables and to decrease screen time and consumption of sugar-sweetened beverages . The intervention programme consisted of a classroom component , including dietary behaviour lessons , computer tailoring , fruit/vegetable and PA breaks , and posters , and an environmental component including active transport campaigns , equipment , suggestions for easy improvements of schoolyards , inspirational courses for teachers ( all with regards to PA ) , and fact sheets to parents . The effect of the intervention programme is evaluated in a cluster r and omised controlled trial design ( intervention = 12 schools , control = 25 schools ) including process evaluation . Main outcomes include anthropometry , PA , screen time , and consumption of fruit , vegetables , and sugar-sweetened beverages . A 2-week test— retest study was conducted among 114 pupils . Determinants of the behaviours were assessed . Similar data were collected from parents . Children ’s PA was measured objective ly by accelerometers . Conclusions : The HEIA study represents a theoretically informed r and omised trial comprising a comprehensive set of multilevel intervention components with a thorough evaluation using reliable outcome measures . The study will contribute to a better underst and ing of determinants of healthy weight development among young people and how such determinants can be modified Studies of youth athletics and interventions have shown some maintenance of bone mineral content ( BMC ; g ) after cessation of training , but less is known about sustained effects of everyday physical activity ( PA ) . Using a prospect i ve cohort , this report examined potential effects of  childhood PA  on  adolescent BMC . Participants ( N=156 boys , 170 girls ) had exams at ages 5 , 13 , and 15 . Body size and maturity were determined using anthropometry . Moderate-to-vigorous-intensity PA ( MVPA ) and vigorous-intensity PA ( Vigorous PA ) were measured using accelerometry .  BMC of the spine and hip was measured using dual-energy X-ray absorptiometry . Mixed regression models tested whether PA at age 5 affected BMC at ages 13 and 15 after adjustment for age ( year ) , height ( cm ) , weight ( kg ) , maturity ( pre-peak height velocity or post ) , and activity level ( min/day ) . Analysis was repeated to control for age 5 BMC . On average , boys participated in 59 , 52 , and 38 min of MVPA and 13 , 17 , and 11 min of Vigorous PA at ages 5 , 13 , and 15 , respectively . MVPA ( β=0.799 ) and Vigorous PA ( β=1.338 ) at age 5 predicted later spine BMC ( p<0.05 ) . MVPA ( β=0.480 ) at age 5 predicted hip BMC . Girls participated in 47 , 33 , and 26 min of MVPA and 10 , 9 and 7 min of Vigorous PA at ages 5 , 13 , and 15 , respectively . Neither MVPA nor Vigorous PA  predicted later spine BMC . MVPA ( β=0.302 ) at age 5 predicted hip BMC . After controlling for BMC at age 5 as well as the other covariates , the effect of MVPA ( β=0.695 ) and Vigorous PA ( β=1.079 ) at age 5 remained significant for boys at the spine . For girls , neither MVPA nor Vigorous PA at age 5 predicted spine or hip BMC . Children 's early PA  appears to have a modest effect on  adolescent BMC at the critical regions of spine and hip ; benefits may be greater for geometric changes , which future studies should include Purpose . The purpose of this study was to test if moderate to vigorous physical activity ( MVPA ) in less than the recommended ≥ 10-minute bouts related to weight outcomes . Design . Secondary data analysis . Setting . R and om sample from the U.S. civilian noninstitutionalized population included in the National Health and Nutrition Examination Survey ( NHANES ) . Participants . A total of 4511 adults aged 18 to 64 years from the 2003–2006 NHANES . Method . Clinical ly measured body mass index ( BMI ) and overweight/obese status were regressed on accelerometer measures of minutes per day in higher-intensity long bouts ( ≥ 10 minutes , ≥ 2020 accelerometer counts per minute [ cpm ] ) , higher-intensity short bouts ( < 10 minutes , ≥ 2020 cpm ) , lower-intensity long bouts ( ≥ 10 minutes , 760–2019 cpm ) , and lower-intensity short bouts ( < 10 minutes , 760–2019 cpm ) . Socioeconomic and demographic characteristics were controlled . Results . Both higher-intensity short bouts and long bouts of PA  related to lower BMI and risk of overweight/obesity . Neither lower-intensity short bouts nor long bouts related to BMI or risk of overweight/obesity Conclusion . The current ≥ 10-minute MVPA bouts guideline was based on health benefits other than weight outcomes . Our findings showed that for weight gain prevention , accumulated higher-intensity PA bouts of < 10 minutes are highly beneficial , supporting the public health promotion message that “ every minute counts . BACKGROUND American workers spend 70 - 80 % of their time at work being sedentary . Traditional approaches to increase moderate-vigorous physical activity ( MVPA ) may be perceived to be harmful to productivity . Approaches that target reductions in sedentary behavior and /or increases in st and ing or light-intensity physical activity [ LPA ] may not interfere with productivity and may be more feasible to achieve through small changes accumulated throughout the workday METHODS / DESIGN : This group r and omized trial ( i.e. , cluster r and omized trial ) will test the relative efficacy of two sedentary behavior focused interventions in 24 worksites across two states ( N=720 workers ) . The MOVE+ intervention is a multilevel individual , social , environmental , and organizational intervention targeting increases in light-intensity physical activity in the workplace . The ST AND + intervention is the MOVE+ intervention with the addition of the installation and use of sit-st and workstations to reduce sedentary behavior and enhance light-intensity physical activity opportunities . Our primary outcome will be objective ly-measured changes in sedentary behavior and light-intensity physical activity over 12months , with additional process measures at 3months and longer-term sustainability outcomes at 24months . Our secondary outcomes will be a clustered cardiometabolic risk score ( comprised of fasting glucose , insulin , triglycerides , HDL-cholesterol , and blood pressure ) , workplace productivity , and job satisfaction DISCUSSION : This study will determine the efficacy of a multi-level workplace intervention ( including the use of a sit-st and workstation ) to reduce sedentary behavior and increase LPA and concomitant impact on cardiometabolic health , workplace productivity , and satisfaction . TRIAL REGISTRATION Clinical Trials.gov Identifier : NCT02566317 ( date of registration : 10/1/2015 ) BACKGROUND Although school-based behavioral interventions for increasing physical activity ( PA ) in children and adolescents have been conducted , little evidence suggests that these curriculum-based approaches lead to increases in overall activity outside of program days . The overall goal of the " Active by Choice Today " ( ACT ) trial is to exp and the body of knowledge concerning the factors that influence long-term increases in PA in underserved adolescents ( low socioeconomic status , minorities ) during their middle school years . DESIGN AND SETTING An overview of the ACT study design , theoretical framework , process evaluation , and primary hypotheses is presented . The trial involves twenty-four middle schools ( 1560 6th grade rs ) in South Carolina that are r and omly assigned to one of two after-school programs ( motivational and life skills intervention , or general health education ) .  INTERVENTION The intervention integrates constructs from Self-Determination and Social Cognitive Theories to enhance intrinsic motivation and behavioral skills for PA . The intervention targets skill development for PA outside of program days and the after-school program social environment ( autonomy , choice , participation , belongingness , fun , enjoyment , support ) is design ed to positively impact cognitive mediators ( self-efficacy , perceived competence ) , and motivational orientation ( intrinsic motivation , commitment , positive self-concept ) . MAIN HYPOTHESES/ OUTCOMES : It is hypothesized that the 17-week motivational and life skills intervention will lead to greater increases in moderate-to-vigorous PA ( based on 7-day accelerometry estimates ) at post-intervention as compared to the general health education program . CONCLUSIONS Implication s of this innovative school-based trial are discussed Background Studies relating physical activity ( PA ) to  weight gain in children have produced mixed results , although there is some evidence for stronger associations with more intense physical activities . The present study tested the hypothesis that weight gain over one year in 8–10 year olds would be more strongly predicted by moderate and vigorous physical activity ( MVPA ) than total physical activity ( total PA ) or sedentary behaviour . Methodology Participants were 280 children taking part in the Physical Exercise and Appetite in Children Study ( PEACHES ) .  Weight status was assessed using body mass index ( BMI ) , fat mass index ( FMI ) , and waist circumference ( WC ) in school Year 4 ( baseline ; age 8.7 yrs ) and Year 5 ( follow-up ; age 9.7 yrs ) .  Physical activity  was measured at baseline using the Actigraph GT1 M accelerometer to assess total PA ( mean accelerometers counts per minute ) , MVPA ; ≥4000 counts per minute ) and sedentary time  ( < 100 counts per minute ) . Principal Findings After adjustment for baseline BMI , SES , sex and ethnicity , MVPA  was significantly associated with follow – up BMI ( adjusted β = −0.07 ; p = 0.002 ) . This association was independent of total PA or sedentary time  . Similar results were observed for FMI ; again MVPA was significantly associated with follow up FMI ( β = −0.16 ; p = 0.001 ) independent  of total PA or sedentary time . The pattern was similar for WC ( β = −0.07 ) , but the association between MVPA and WC did not reach significance at p = 0.06 . Conclusion The results of this study strongly support promotion of MVPA in children INTRODUCTION Replacing sedentary behaviour with light intensity physical activity ( ie , activities classified as less than three metabolic equivalents , such as slow-paced walking ) may be a more realistic strategy for reducing cardiometabolic risk in people with chronic obstructive pulmonary disease than only aim ing to increase levels of moderate-vigorous intensity physical activity . Behaviour change interventions to reduce sedentary behaviour in people with chronic obstructive pulmonary disease have not yet been developed or tested . RESEARCH QUESTIONS Is a 6-week behaviour change intervention effective and feasible in reducing sedentary time in people with chronic obstructive pulmonary disease ? DESIGN This study will be a multi-centre , r and omised , controlled trial with concealed allocation , assessor blinding , and intention-to-treat analysis , comparing a 6-week behaviour change intervention aim ed at reducing sedentary time with a sham intervention in people with chronic obstructive pulmonary disease . PARTICIPANTS AND SETTING Seventy participants will be recruited from the waiting lists for pulmonary rehabilitation programs at Royal Prince Alfred Hospital and Prince of Wales Hospital , Sydney , Australia . INTERVENTION The behaviour change intervention aims to reduce sedentary time through a process of guided goal setting with participants to achieve two target behaviours : ( 1 ) replace sitting and lying down with light-intensity physical activity where possible , and ( 2 ) st and up and move for 2minutes after 30minutes of continuous sedentary time . Three face-to-face sessions and three phone sessions will be held with a physiotherapist over the 6-week intervention period . The ' capability ' , ' opportunity ' , ' motivation ' and ' behaviour ' ( COM-B ) model will be applied to each participant to determine which components of behaviour ( capability , opportunity or motivation ) need to change in order to reduce sedentary time . Based on this ' behavioural diagnosis ' , the Behaviour Change Wheel will be used to systematic ally select appropriate behaviour change techniques to assist participants in achieving their weekly goals . Behaviour change techniques will include providing information about the health consequences of sedentary behaviour , self-monitoring and review of weekly goals , problem-solving of barriers to achieving weekly goals , and providing feedback on sedentary time using the Jawbone UP3 activity monitor . CONTROL The sham intervention will consist of weekly phone calls for 6 weeks , to enquire whether the participants ' health status has changed over the intervention period ( eg , hospitalised for an acute exacerbation ) . No instructions regarding physical activity or exercise will be given . MEASUREMENTS Outcomes will be assessed at baseline , at the end of the 6-week intervention period , and at the 3-month follow-up . Primary outcome measures will be : ( 1 ) total sedentary time , including the pattern of accumulation of sedentary time , assessed by the activPAL3 activity monitor , and ( 2 ) feasibility of the intervention assessed by uptake and retention of participants , participant compliance , self-reported achievement of weekly goals , and adverse events . Secondary outcome measures will include functional exercise capacity , health-related quality of life , domain-specific and behaviour-specific sedentary time , patient activation , and anxiety and depression .  Semi-structured interviews will be conducted with participants who receive the behaviour change intervention to explore acceptability and satisfaction with the different components of the intervention . ANALYSIS Analysis of covariance ( ANCOVA ) will be used to calculate between-group comparisons of total sedentary time and the number of bouts of sedentary time>30minutes after adjusting baseline values . Uncertainty about the size of the mean between-group differences will be quantified with 95 % CI . Within-group comparisons will be examined using paired t-tests and described as mean differences with 95 % CIs . Secondary outcome measures will be analysed similarly . The feasibility measures will be analysed descriptively . Semi-structured interviews will be conducted until data saturation is achieved and there are no new emerging themes . De-identified interview transcripts will be coded independently by two research ers and analysed alongside data collection using the COM-B model as a thematic framework . DISCUSSION / SIGNIFICANCE If behaviour change interventions are found to be an effective and feasible method for reducing sedentary time , such interventions may be used to reduce cardiometabolic risk in people with chronic obstructive pulmonary disease . An approach that emphasises participation in light-intensity physical activity may increase the confidence and willingness of people with chronic obstructive pulmonary disease to engage in more intense physical activity , and may serve as an intermediate goal to increase uptake of pulmonary rehabilitation PURPOSE AND METHODS Although evidence is accumulating that sedentary behavior ( SB ) , independent of moderate-to-vigorous intensity physical activity ( MVPA ) , is associated with cardiometabolic and aging outcomes in adults , several gaps present opportunities for future research . This article reports on the " Research Evidence on Sedentary Behavior " session of the Sedentary Behavior : Identifying Research Priorities workshop , sponsored by the National Heart , Lung , and Blood Institute and the National Institute on Aging , which aim ed to identify priorities in SB research . RESULTS AND CONCLUSIONS A consensus definition of SB has not yet been established , although agreement exists that SB is not simply all behaviors other than MVPA . The two most common definitions are as follows : one based solely on intensity ( < 1.5 metabolic equivalents [ METs ] ) and another which combines low intensity ( ≤1.5 METs ) with a seated or reclining posture . Thus , for the definition of SB , evaluation of whether or not to include a postural component is a research priority . SB assessment method ologies include self-report and objective measurement , each offering distinct information . Therefore , evaluation , st and ardization , and comparison across self-report and objective assessment methods are needed . Specific priorities include the development and validation of novel devices capable of assessing posture and st and ardization of research practice s for SB assessment by accelerometry . The prospect i ve evidence that SB relates to health outcomes is limited in that SB is almost exclusively measured by self-report . The lack of longitudinal studies with objective ly measured SB was recognized as a major research gap , making examination of the association between objective ly measured SB and adverse health outcomes in longitudinal studies a research priority . Specifically , studies with repeated measures of SB , evaluating dose-response relationships , with inclusion of more diverse population s are needed PURPOSE The efficacy of a home-based physical activity ( PA ) intervention for early-stage breast cancer patients was evaluated in a r and omized controlled trial . PATIENTS AND METHODS Eighty-six sedentary women ( mean age , 53.14 years ; st and ard deviation , 9.70 years ) who had completed treatment for stage 0 to II breast cancer were r and omly assigned to a PA or contact control group . Participants in the PA group received 12 weeks of PA counseling ( based on the Transtheoretical Model ) delivered via telephone , as well as weekly exercise tip sheets . Assessment s were conducted at baseline , after treatment ( 12 weeks ) , and 6 and 9 month after baseline follow-ups . The post-treatment outcomes are reported here . RESULTS Analyses showed that , after treatment , the PA group reported significantly more total minutes of PA , more minutes of moderate-intensity PA , and higher energy expenditure per week than controls . The PA group also out-performed controls on a field test of fitness . Changes in PA were not reflected in objective activity monitoring . The PA group was more likely than controls to progress in motivational readiness for PA and to meet PA guidelines . No significant group differences were found in body mass index and percent body fat . Post-treatment group comparisons revealed significant improvements in vigor and a reduction in fatigue in the PA group . There was a positive trend in intervention effects on overall mood and body esteem . CONCLUSION The intervention successfully increased PA and improved fitness and specific aspects of psychological well-being among early-stage breast cancer patients . The success of a home-based PA intervention has important implication s for promoting recovery in this population OBJECTIVE To describe the patterns ( specifically comparing weekdays and weekends classified by intensities ) of  physical activity ( PA ) measured by accelerometry in adolescent girls . RESEARCH METHODS AND PROCEDURES Healthy sixth grade girls ( n=1603 ) , 11 to 12 years old , were r and omly recruited from 36 schools participating in the Trial of Activity in Adolescent Girls . Age , ethnicity , socioeconomic status , weight , and height were taken .  PA patterns were measured for 6 days using accelerometry . RESULTS Adolescent girls spend most of their time in  sedentary  ( 52 % to 57 % of the day ) and  light activity ( 40 % to 45 % of the day ) on weekdays and weekends . In all girls , total PA  comprised 44.5 % of the day ( 41.7 % light , 2.2 % moderate , and 0.7 % vigorous ) with sedentary activity comprising 55.4 % .  Moderate-to-vigorous PA ( MVPA )  was higher ( p<0.001 ) on weekdays than weekends in all girls , but  MVPA  was lower in at-risk of overweight+overweight girls ( p<0.001 ) on both weekdays and weekends compared with normal-weight girls . DISCUSSION Adolescent girls are more active at moderate and vigorous intensities on weekdays than on weekends , and at-risk of overweight and those overweight spend less time engaging in  MVPA  than normal-weight girls Background The purpose was to conduct systematic review s of the relationship between physical activity of healthy community-dwelling older ( > 65 years ) adults and outcomes of  functional limitations , disability , or loss of independence .  Methods Prospect i ve cohort studies with an outcome related to functional independence or to cognitive function  were search ed , as well as exercise training interventions that reported a functional outcome . Electronic data base search strategies were used to identify citations which were screened ( title and abstract ) for inclusion . Included articles were review ed to complete st and ardized data extraction tables , and assess study quality . An established system of assessing the level and grade of evidence for recommendations was employed . Results Sixty-six studies met inclusion criteria for the relationship between physical activity and functional independence , and 34 were included with a cognitive function outcome . Greater physical activity of an aerobic nature ( categorized by a variety of methods ) was associated with higher functional status ( expressed by a host of outcome measures ) in older age . For functional independence , moderate ( and high ) levels of physical activity appeared effective in conferring a reduced risk ( odds ratio ~0.5 ) of functional limitations or disability . Limitation in higher level performance outcomes was reduced ( odds ratio ~0.5 ) with vigorous ( or high ) activity with an apparent dose-response of moderate through to high activity . Exercise training interventions ( including aerobic and resistance ) of older adults showed improvement in physiological and functional measures , and suggestion of longer-term reduction in incidence of mobility disability . A relatively high level of physical activity was related to better cognitive function and reduced risk of developing dementia ; however , there were mixed results of the effects of exercise interventions on cognitive function indices . Conclusions There is a consistency of findings across studies and a range of outcome measures related to functional independence ; regular aerobic activity and short-term exercise programmes confer a reduced risk of functional limitations and disability in older age . Although a precise characterization of a minimal or effective physical activity dose to maintain functional independence is difficult , it appears moderate to higher levels of activity are effective and there may be a threshold of at least moderate activity for significant outcomes PURPOSE  Physical activity ( PA  ) declines dramatically during adolescence , and activity levels are consistently lower among children living in low-income communities . Competency in a range of fundamental movement skills ( FMS ) may serve as a protective factor against the decline in PA typically observed during adolescence . The purpose of this study was to evaluate the effect of a 12-month multicomponent PA and FMS intervention on children attending primary schools in low-income communities . METHODS The Supporting Children 's Outcomes using Rewards , Exercise , and Skills intervention was evaluated using a cluster r and omized controlled trial . The sample included 25 classes from eight primary schools located in low-income communities . Participants were 460 children ( 54.1 % girls ) age 8.5 ± 0.6 yr . Primary outcomes were objective ly measured PA ( ActiGraph GT3X and GT3X+ accelerometers ) , FMS competency ( Test of Gross Motor Development 2 , six locomotor and six object control skills ) , and cardiorespiratory fitness ( 20-m multistage fitness test ) assessed at baseline , midprogram ( 6-months ) , and at posttest ( 12 months ) . Linear mixed models , adjusted for sex , age , body mass index z-score , socioeconomic status , ethnicity , and school class as a r and om factor , were used to assess the effect of the intervention . RESULTS At midprogram , there were no significant intervention effects for any of the outcomes . At posttest ( study 's primary time point ) , there were intervention effects for daily moderate-to-vigorous PA ( MVPA ) ( adjusted mean difference , 12.7 min·d of MVPA ; 95 % confidence interval ( CI ) , 5.0 - 20.5 ) , overall FMS competency ( 4.9 units ; 95 % CI , -0.04 to 9.8 ) , and cardiorespiratory fitness ( 5.4 laps ; 95 % CI , 2.3 - 8.6 ) . CONCLUSIONS A school-based multicomponent PA and FMS intervention maintained daily MVPA , improved overall FMS competency , and increased cardiorespiratory fitness among children attending primary schools in low-income communities Objective . To determine if a 10-month after-school physical activity ( PA ) intervention could prevent deleterious changes in body composition and cardiovascular ( CV ) fitness in young black boys . Methods . Following baseline measures , 106 boys ( 8–12 yrs ) were r and omized to either a control group or an intervention group , further divided into attenders ( ATT ) and nonattenders ( NATT ) , participating in ≥60 % or < 60 % of the intervention , respectively . The daily intervention consisted of skills development ( 25 min ) , vigorous PA ( VPA , 35 min ) , and strengthening/stretching ( 20 min ) components . Body composition was measured by dual-energy X-ray absorptiometry . Results . Following the intervention , the ATT exhibited an increase in moderate-to-vigorous PA and a significant reduction in BMI , fat mass , and % BF compared to the control group . A significant association among the intervention energy expenditure and changes in body composition and CV fitness was observed only in the ATT group . Conclusion . An after-school PA program of sufficient length and intensity can promote healthy changes in body composition and fitness levels in black boys who attend at least 3 days/week Background This study aim ed to evaluate the associations of selected demographic , individual , social , and environmental factors with moderate-to-vigorous physical activity ( MVPA ) in a sample of children and adolescents . Methods  MVPA  was assessed among youth ( n = 294 ) 10 - 17-years-old using the ActiGraph accelerometer . Youth completed measures of demographic and individual variables related to physical activity ( PA ) , perceived social support by parents and peers , and perceived neighborhood characteristics . Parents completed the long-form of the International Physical Activity Question naire . The Physical Activity and Media Inventory was used to measure the home environment and Geographical Information Systems software was used to measure the physical neighborhood environment . Bivariate correlations and hierarchical multiple regression were conducted stratified by gender . Results Boys participated in significantly more MVPA than girls . In hierarchical analyses , peer support , home PA equipment , and temperature were significantly associated with MVPA among boys whereas distance to the school they attended was associated with MVPA among girls . The final models accounted for 25 % and 15 % of the variance in MVPA among boys and girls , respectively . Conclusions Important differences exist among the individual , social , and environmental factors related to MVPA between boys and girls . Boys ' levels of activity appear to be influenced by factors closely linked to unstructured and social types of activities whereas girls ' activities relate to internal and external barriers as well as their proximity to their schools . The prospect i ve contribution of these important individual , social , and environmental factors to changes in MVPA among children and adolescents remains to be determined BACKGROUND Remote and web 2.0 interventions for promoting physical activity ( PA ) are becoming increasingly popular but their ability to achieve long term changes are unknown . OBJECTIVES To compare the effectiveness of remote and web 2.0 interventions for PA promotion in community dwelling adults ( aged 16 years and above ) with a control group exposed to placebo or no or minimal intervention . SEARCH METHODS We search ed CENTRAL , MEDLINE , EMBASE , CINAHL , and some other data bases ( from earliest date s available to October 2012 ) . Reference lists of relevant articles were checked . No language restrictions were applied . SELECTION CRITERIA R and omised controlled trials ( RCTs ) that compared remote and web 2.0 PA interventions for community dwelling adults with a placebo or no or minimal intervention control group .  We included studies if the principal component of the intervention was delivered using remote or web 2.0 technologies ( for example the internet , smart phones ) or more traditional methods ( for example telephone , mail-outs ) , or both . To assess behavioural change over time , the included studies had a minimum of 12 months follow-up from the start of the intervention to the final results . We excluded studies that had more than a 20 % loss to follow-up if they did not apply an intention-to-treat analysis . DATA COLLECTION AND ANALYSIS At least two authors independently assessed the quality of each study and extracted the data . Non-English language papers were review ed with the assistance of an interpreter who was an epidemiologist . Study authors were contacted for additional information where necessary . St and ardised mean differences ( SMDs ) and 95 % confidence intervals ( CIs ) were calculated for the continuous measures of self-reported PA and cardio-respiratory fitness . For studies with dichotomous outcomes , odds ratios and 95 % CIs were calculated . MAIN RESULTS A total of 11 studies recruiting 5862 apparently healthy adults met the inclusion criteria . All of the studies took place in high-income countries . The effect of the interventions on cardiovascular fitness at one year ( two studies ; 444 participants ) was positive and moderate with significant heterogeneity of the observed effects ( SMD 0.40 ; 95 % CI 0.04 to 0.76 ; high quality evidence ) . The effect of the interventions on self-reported PA at one year ( nine studies ; 4547 participants ) was positive and moderate ( SMD 0.20 ; 95 % CI 0.11 to 0.28 ; moderate quality evidence ) with heterogeneity ( I2 = 37 % ) in the observed effects . One study reported positive results at two years ( SMD 0.20 ; 95 % CI 0.08 to 0.32 ; moderate quality evidence ) . When studies were stratified by risk of bias , the studies at low risk of bias ( eight studies ; 3403 participants ) had an increased effect ( SMD 0.28 ; 95 % CI 0.16 to 0.40 ; moderate quality evidence ) . The most effective interventions applied a tailored approach to the type of PA and used telephone contact to provide feedback and to support changes in PA levels . There was no evidence of an increased risk of adverse events ( seven studies ; 2892 participants ) . Risk of bias was assessed as low ( eight studies ; 3060 participants ) or moderate ( three studies ; 2677 participants ) . There were no differences in effectiveness between studies using different types of professionals delivering the intervention ( for example health professional , exercise specialist ) . There was no difference in pooled estimates between studies that generated the prescribed PA using an automated computer programme versus a human , nor between studies that used pedometers as part of their intervention compared to studies that did not . AUTHORS ' CONCLUSIONS We found consistent evidence to support the effectiveness of remote and web 2.0 interventions for promoting PA . These interventions have positive , moderate sized effects on increasing self-reported PA and measured cardio-respiratory fitness , at least at 12 months . The effectiveness of these interventions was supported by moderate and high quality studies . However , there continues to be a paucity of cost effectiveness data and studies that include participants from varying socioeconomic or ethnic groups . To better underst and the independent effect of individual programme components , longer term studies , with at least one year follow-up , are required Objective To assess relationships between current physical activity ( PA ) , dietary intake and body mass index (  BMI ) in English children . Design and setting Longitudinal birth cohort study in northeast Engl and , cross-sectional analysis . Participants 425 children ( 41 % of the original cohort ) aged 6–8 years ( 49 % boys ) . Main outcome measures  PA  over 7 days was measured objective ly by an accelerometer ; three categories of PA were created : ‘ active ’ ≥60 min/day moderate-to-vigorous-intensity PA ( MVPA ) ; ‘ moderately active ’ 30–59 min/day MVPA ; ‘ inactive ’ < 30 min/day MVPA . Dietary intake  over 4 days was measured using a prospect i ve dietary assessment tool which incorporated elements of the food diary and food frequency methods . Three diet categories were created : ‘ healthy ’ , ‘ unhealthy ’ and ‘ mixed ’ , according to the number of portions of different foods consumed . Adherence to the ‘ 5-a-day ’ recommendations for portions of fruit and vegetables was also assessed . Children were classified as ‘ healthy weight ’ or ‘ overweight or obese ’ ( OW/OB ) according to International Obesity Taskforce cutpoints for BMI . Associations between weight status and PA/diet categories were analysed using logistic regression . Results Few children met the UK-recommended guidelines for either MVPA or fruit and vegetable intake , with just 7 % meeting the recommended amount of MVPA of 60 min/day , and 3 % meeting the 5-a-day fruit and vegetable recommendation .  Higher PA  was associated with a lower OR for OW/OB in boys only ( 0.20 , 95 % CI 0.04 to 0.88 ) . There was no association detected between dietary intake and OW/OB in either sex . Conclusions Increasing MVPA may help to reduce OW/OB in boys ; however , more research is required to examine this relationship in girls . Children are not meeting the UK guidelines for diet and PA , and more needs to be done to improve this situation Background To investigate the interpersonal and physical environment mediators of the Transform-Us ! mid-intervention effects on  physical activity ( PA )  during recess and lunchtime . Methods Transform-Us ! is a clustered r and omised school-based intervention with four groups : sedentary behaviour intervention ( SB-I ) , PA intervention ( PA-I ) , combined PA+SB-I and control group .  All children in grade 3 from 20 participating primary schools in Melbourne , Australia were eligible to complete annual evaluation assessment s. The outcomes were the proportion of time spent in moderate-to-vigorous PA ( MVPA ) and light PA ( LPA )  during recess and lunchtime assessed by accelerometers . Potential mediators included : perceived social support from teachers ; perceived availability of line markings ; perceived accessibility of sports equipment ; and perceived school play environment . Generalised linear models were used and mediation effects were estimated by product-of-coefficients ( a·b ) approach . Results 268 children ( 8.2 years , 57 % girls at baseline ) provided complete data at both time points . A significant intervention effect on MVPA during recess in the SB-I and PA-I groups compared with the control group ( proportional difference in MVPA time ; 38 % ( 95 % CI 21 % to 57 % ) and 40 % ( 95 % CI 20 % to 62 % ) , respectively ) was found . The perceived school play environment was significantly positively associated with MVPA at recess among girls . An increase in perceived social support from teachers suppressed  the PA+SB-I effect on light PA  during recess ( a·b= −0.03 , 95 % CI −0.06 to −0.00 ) . No significant mediating effects  on PA during recess and lunchtime were observed . Conclusions A positive perception of the school play environment was associated with higher MVPA during recess among girls . Future studies should conduct mediation analyses to explore underlying mechanisms of PA interventions Background The minimal effect of interventions to date on increasing young adolescent girls ’ physical activity ( PA ) may be due to inadequate underst and ing of the mechanisms underlying behavior change , yet sparse research testing a PA intervention has examined the capacity of theories to explain PA , particularly when using objective measures . Objectives The aim of the study was to examine whether constructs from the health promotion model and self-determination theory mediated changes in moderate-to-vigorous physical activity ( MVPA ) following a 17-week intervention . Methods The study was a secondary analysis of data from a group r and omized trial , including 12 intervention and 12 control schools in the Midwestern United States . Data were collected in 2012–2016 . Girls ( fifth- to eighth- grade , N = 1,519 ) completed surveys on  perceived benefits and enjoyment of PA , PA self-efficacy , social support and motivation for PA , and barriers to PA and wore accelerometers . Results The final path model had a good fit : χ2(4 ) = 2.48 , p = .648 ; goodness-of-fit index = 1 ; comparative fit index = 1 ; root-mean-square error of approximation = 0 ; st and ardized root-mean-square residual = 0.01 . For MVPA change from baseline to postintervention , enjoyment ( B = 24.48 , p < .001 ) and social support ( B = 30.48 , p < .001 ) had a positive direct effect , whereas the intervention had a positive indirect effect through enjoyment and social support ( B = 9.13 , p < .001 ) . Enjoyment ( B = −13.83 , p < .001 ) and social support ( B = −17.22 , p < .001 ) had a negative indirect effect on MVPA change from postintervention to follow-up . Discussion Enjoyment of PA and social support for PA may be important mediators of  PA in young adolescent girls and warrant consideration when design ing interventions Background  Physical activity ( PA )  in children has declined in recent decades , highlighting the need for effective intervention programs for school-aged children . The main objective of this study was to assess to what extent PA during and after school hours changed among children who received a progressive two-year long intervention vs. that of children who only received general curriculum-based PA .  Methods A cluster r and omized intervention study was conducted and six elementary schools r and omly assigned to serve as control- or intervention schools . All children attending second grade ( mean age = 7.4 years - born in 1999 ) were invited to participate in the fall of 2006 ( N = 320 , 82 % participated ) , again in 2007 ( midpoint ) and 2008 ( end of intervention ) . The intervention consisted of multi-component PA-intervention during school hours and was conducted by teachers at each intervention school . PA  was assessed by means of accelerometers and subjectively at the intervention schools via teachers ' PA log-books . Results There was no difference in PA intensity ( minutes of moderate-to-vigorous physical activity - min of MVPA ) between the two study groups at baseline , but children in the intervention schools were more physically active at moderate-to-vigorous intensity compared to those in control schools after one year of intervention ( mean difference of MVPAlog-minutes : 0.61 , 95%CI : 0.02 , 1.20 , p = 0.04 ) . Moreover , the model for minutes of MVPA during school hours , showed a significant three-way interaction between time at mid-point , group and gender ( mean difference of MVPAlog-minutes : 1.06 , 95%CI : 0.15 , 1.97 , p = .02 ) , indicating a significantly greater increase among the boys in the intervention schools compared to girls . No difference in PA was detected between the study groups at the end of the study period after two years of intervention . Conclusions The results suggest that the objective of increasing PA at school was met after one year of intervention , and it was more pronounced among boys . The lack of increase at the end of the study period suggested that any increase in  PA  during school may highly depend on both motivation and training of general teachers . Boys may respond better to PA interventions such as the one described in this study BACKGROUND Previous research suggests motivation , enjoyment , and self-efficacy may be important psychosocial factors for underst and ing physical activity ( PA ) in youth . While previous studies have shown mixed results , emerging evidence indicates relationships between psychosocial factors and PA may be stronger in boys than girls . This study exp and s on previous research by examining the effects of motivation , enjoyment and self-efficacy on PA in underserved adolescent ( low income , ethnic minorities ) boys and girls . Based on previous literature , it was hypothesized the effects of motivation , enjoyment and self-efficacy on  moderate-to-vigorous PA ( MVPA )  would be stronger in boys than in girls . METHODS Baseline cross-sectional data were obtained from a r and omized , school-based trial ( Active by Choice Today ;  ACT ) in underserved 6th grade rs ( N=771 girls , 651 boys ) . Intrapersonal variables for PA were assessed via self-report and confirmatory factor analyses were conducted for each predictor .  MVPA  was assessed with 7-day accelerometry estimates . RESULTS Multivariate regression analyses stratified by sex demonstrated a significant positive main effect of self-efficacy and motivation on MVPA for girls . Boys also showed a positive trend for the effect of motivation on MVPA . CONCLUSIONS The results from this study suggest motivation and self-efficacy should be better integrated to facilitate the development of more effective interventions for increasing PA in underserved adolescents
Overall , total PA was favourably associated with physical , psychological/social , and cognitive health indicators .
Relationships were more consistent and robust for higher ( e.g. , MVPA ) versus lower ( e.g. , LPA ) intensity PA .
All patterns of activity ( sporadic , bouts , continuous ) provided benefit .
LPA was favourably associated with cardiometabolic biomarkers ; data were scarce for other outcomes .
These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth , but also highlight the potential benefits of LPA and total PA .
Moderate-to-vigorous physical activity ( MVPA ) is essential for disease prevention and health promotion .
Emerging evidence suggests other intensities of physical activity ( PA ) , including light-intensity activity ( LPA ) , may also be important , but there has been no rigorous evaluation of the evidence .
The purpose of this systematic review was to examine the relationships between objective ly measured PA ( total and all intensities ) and health indicators in school-aged children and youth .
Online data bases were search ed for peer- review ed studies that met the a priori inclusion criteria : population ( apparently healthy , aged 5 - 17 years ) , intervention/exposure/comparator ( volumes , duration s , frequencies , intensities , and patterns of objective ly measured PA ) , and outcome ( body composition , cardiometabolic biomarkers , physical fitness , behavioural conduct/pro-social behaviour , cognition/academic achievement , quality of life/well-being , harms , bone health , motor skill development , psychological distress , self-esteem ) .