Observed levels of elementary and middle school children's physical activity during physical education classes. School physical education: effect of the Child and Adolescent Trial for Cardiovascular Health. Effects of school-based interventions on mental health stigmatization: a systematic review Evidence-based recommendations for monitoring safety of second-generation antipsychotics in children and youth. Will they stay fit and healthy? A three-year follow-up evaluation of a physical activity and health intervention in Polish youth Benefits of Strength and Skill-based Training During Primary School Physical Education Effects of a physical activity programme in the school setting on physical fitness in preschool children Methods of the NSW Schools Fitness and Physical Activity Survey, 1997. 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. Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents 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 Examining the impact of 45 minutes of daily physical education on cognitive ability, fitness performance, and body composition of African American youth. Improving health-related fitness in children: the fit-4-Fun randomized controlled trial study protocol Exercise for people with cancer: a clinical practice guideline. Correlates of cardiorespiratory and muscular fitness among Brazilian adolescents. Proposal for an Enhanced Physical Education Program in the Primary School: Evaluation of Feasibility and Effectiveness in Improving Physical Skills and Fitness. Effects of a physical education program on physical activity, fitness, and health in children: the JuvenTUM project. Health-related fitness in school children: compliance with physical activity recommendations and its relationship with body mass index and diet quality. Long term health implications of fitness and physical activity patterns. Intervening to Reduce Sedentary Behaviors and Childhood Obesity among School-Age Youth: A Systematic Review of Randomized Trials Psychosocial Determinants of Physical Activity in Children Attending Afterschool Programs: A Path Analysis 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] Examining the theory‐effectiveness hypothesis: A systematic review of systematic reviews Long-Term Effect of a School-Based Physical Activity Program (KISS) on Fitness and Adiposity in Children: A Cluster-Randomized Controlled Trial The Effects of Nutritional-Physical Activity School-based Intervention on Fatness and Fitness in Preschool Children Improving the fitness and physical activity levels of primary school children: results of the Fit-4-Fun group randomized controlled trial. Design of the iPlay Study Changes in physical activity levels, lesson context, and teacher interaction during physical education in culturally and linguistically diverse Australian schools Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: clinical outcomes. Effectiveness of parent‐centred interventions for the prevention and treatment of childhood overweight and obesity in community settings: a systematic review Using Community–Academic Partnerships and a Comprehensive School-Based Program to Decrease Health Disparities in Activity in School-Aged Children Health promotion intervention in low socioeconomic kindergarten children.
BACKGROUND The benefits of childhood physical activity include fitness , weight control , and exercise habits that may carry over into adulthood . School physical education is the primary program responsible for training the nation 's youth to be physically active and national objectives call for students to be engaged in moderate-to-vigorous physical activity at least 50 % of class time . The purpose of this study was to determine through systematic observation in a regional sample of elementary and middle schools the amount of moderate-to-vigorous physical activity students obtain during physical education classes . METHODS Twenty elementary schools and 7 middle schools were r and omly sample d from the 355 elementary schools and 117 middle schools in the 20 school districts in Harris County , Texas . In addition , 9 elementary and 6 middle schools that were identified as having excellent physical education programs were sample d purposively to provide a comparison . Seven systematic observations of student 's physical activity were conducted during physical education in each school . RESULTS The average moderate-to-vigorous physical activity in the r and omly selected elementary schools was 8.6 % , significantly less ( P < 0.05 ) than for the r and omly selected middle schools ( 16.1 % ) or for the comparison elementary schools ( 20.6 % ) and middle schools ( 24.0 % ) . CONCLUSIONS The average amount of  physical activity  observed in this regional sample of schools was less than the estimated national average of 27 % and far less than the national recommendation calling for a minimum of 50 % BACKGROUND Physical inactivity is a risk behavior for cardiovascular and other diseases . Schools can promote public health objectives by increasing physical activity among youth . METHODS The Child and Adolescent Trial for Cardiovascular Health ( CATCH ) was a multicenter , r and omized trial to test the effectiveness of a cardiovascular health promotion program in 96 public schools in four states . A major component of CATCH was an innovative , health-related physical education ( P+ ) program . For 2.5 years , r and omly assigned schools received a st and ardized PE intervention , including curriculum , staff development , and follow-up . RESULTS Systematic analysis of 2,096 PE lessons indicated students engaged in more moderate-to-vigorous physical activity ( MVPA ) in intervention than in control schools ( P = 0.002 ) . MVPA during lessons in intervention schools increased from 37.4 % at baseline to 51.9 % , thereby meeting the established Year 2000 objective of 50 % . Intervention children reported 12 more min of daily vigorous physical activity ( P = 0.003 ) and ran 18.6 yards more than control children on a 9-min run test of fitness ( P = 0.21 ) . CONCLUSIONS The implementation of a st and ardized curriculum and staff development program increased children 's  MVPA in existing school PE classes in four geographic and ethnically diverse communities . CATCH PE provides a tested model for improving physical education in American schools Stigmatizing , or discriminatory , perspectives and behaviour , which target individuals on the basis of their mental health , are observed in even the youngest school children . We conducted a systematic review of the published and unpublished , scientific literature concerning the benefits and harms of school-based interventions , which were directed at students 18 years of age or younger to prevent or eliminate such stigmatization . Forty relevant studies were identified , yet only a qualitative synthesis was deemed appropriate . Five limitations within the evidence base constituted barriers to drawing conclusive inferences about the effectiveness and harms of school-based interventions : poor reporting quality , a dearth of r and omized controlled trial evidence , poor methods quality for all research design s , considerable clinical heterogeneity , and inconsistent or null results . Nevertheless , certain suggestive evidence derived both from within and beyond our evidence base has allowed us to recommend the development , implementation and evaluation of a curriculum , which fosters the development of empathy and , in turn , an orientation toward social inclusion and inclusiveness . These effects may be achieved largely by bringing especially but not exclusively the youngest children into direct , structured contact with an infant , and likely only the oldest children and youth into direct contact with individuals experiencing mental health difficulties . The possible value of using educational activities , material s and contents to enhance hypothesized benefits accruing to direct contact also requires investigation . Overall , the curriculum might serve as primary prevention for some students and as secondary prevention for others BACKGROUND The use of antipsychotics , especially second-generation antipsychotics ( SGAs ) , for children with mental health disorders in Canada has increased dramatically over the past five years . These medications have the potential to cause major metabolic and neurological complications with chronic use . OBJECTIVE To synthesize the evidence for specific metabolic and neurological side effects associated with the use of SGAs in children , and provide evidence -based recommendations for the monitoring of these side effects . METHODS A systematic review of controlled clinical trials of SGAs involving children was performed . Recommendations for monitoring SGA safety were made according to a classification scheme based on the GRADE ( Grading of Recommendations Assessment , Development and Evaluation ) system . When there was inadequate evidence , recommendations were based on consensus and expert opinion . A multidisciplinary consensus group review ed all relevant evidence and reached consensus on the recommendations . RESULTS The present guidelines provide evidence -based recommendations for monitoring SGA safety . The strength of recommendations for specific physical examination manoeuvres and laboratory tests are provided for each SGA medication at specific time points . CONCLUSION Multiple r and omized controlled trials evaluated the efficacy of many of the SGAs in paediatric mental health disorders . These benefits , however , are not without risks - both metabolic and neurological side effects occur in children treated with SGAs . The risk of weight gain , increased body mass index and abnormal lipid levels is greatest with olanzapine , followed by clozapine and quetiapine . The risk of neurological side effects of the treatment is greatest with risperidone , olanzapine and aripiprazole . Appropriate monitoring procedures for adverse effects will improve the quality of care of children treated with these medications Aims : In this paper we evaluate the sustainability of changes of involvement in physical activity . The paper examines the effectiveness of a model aim ing at influencing the frequency of leisuretime physical activity , physical fitness and body constituency in youth . Methods : The baseline of this study was a r and omly selected sample of 13 year olds who participated in an intervention programme carried out in three schools in Poznan in 2005—08 . From a total of 199 adolescent boys a sub sample of 38 individuals from the experimental group and 34 from the control group were followed for 15 months after the interventional programme finished . From 170 girls , a sub sample of 33 from the experimental group and 32 girls from the control group were also r and omly selected for the follow-up study . Among the variables monitored were : physical fitness , body constituency , and frequency of leisuretime physical activity . All the variables were monitored in pre-test , post-test and follow-up examinations . Results : It was established that 15 months after the end of the interventional programme boys and girls from the intervention groups maintained a higher level of leisuretime physical activity than their control group peers , and similarly in the case of selected health-related components of physical fitness . No distinctive differences were found in the case of body constituency , though , apart from muscle mass and the sum of skinfolds in girls . Conclusions : The study exposed an increase in leisuretime physical activity in time and a positive influence on selected components of health-related variables . The findings confirm the effectiveness of a multi-level intervention programme involving self-determined out-of-school physical activity planning for school-age youths , indicating the importance of personal and social context Abstract Faigenbaum , AD , Bush , JA , McLoone , RP , Kreckel , MC , Farrell , A , Ratamess , NA , and Kang , J. Benefits of strength and skill-based training during primary school physical education . J Strength Cond Res 29(5 ) : 1255–1262 , 2015—Physical education ( PE ) programs are evolving from a traditional skill-centered model to a health-centered model that focuses on time engaged in moderate to vigorous physical activity ( MVPA ) . However , improvements in muscular fitness and fundamental movement skills are prerequisites for continuous participation in MVPA . The purpose of this study was to examine the effects of integrative strength and skill-based training on measures of physical fitness in children during primary school PE . Children from two fourth grade PE classes were cluster r and omized into either a fundamental integrative training ( FIT ) group ( n = 20 ) or a control ( CON ) group ( n = 21 ) . The 8-week FIT program was performed twice per week during the first ∼15 minutes of each PE class and consisted of a circuit of strength and skill-based exercises . All participants were assessed for health- and skill-related fitness before and after the intervention . The outcome variables were analyzed via 2 × 2 repeated measures analysis of variance with post hoc analysis . A significant ( p ⩽ 0.05 ) interaction of group by time was observed in FIT participants with improvements in aerobic capacity , push-ups , sit and reach flexibility , and single-leg hop . There were no groups by time effects for the sit-up and long jump tests . No injuries were reported . These findings highlight the potential benefits of integrating both health- and skill-related fitness components into primary school PE as evidence d by improvements in measures of aerobic capacity and muscular fitness in children AIM The purpose of this study was to examine the effects of a 10-week aerobic games programme on physical fitness . METHODS One hundred eleven children , aged 3 to 6 years , participated in this study ; 60 children were male ( age : 4.28 ± 0.61 years old ) , and 51 were female ( age 4.59 ± 0.49 years old ) . Participants were r and omly assigned to an experimental group ( EG ; n = 56 ) and a control group ( CG ; n = 55 ) . A fitness test battery previously vali date d for preschoolers was used . The children in the EG performed 3 weekly training sessions of physical activity in a classroom during a 10-week period . Every EG session lasted about 30 min . RESULTS There were no significant differences in any variable in the pretest between groups . In the posttest , the EG achieved better results in horizontal jump and sprint . In relation to posttest-pretest differences , the EG showed a greater increase in horizontal jump , sprint , and endurance . CONCLUSION An aerobic games programme in the school setting improved physical fitness in preschool children Physical fitness , participation in physical activity , fundamental motor skills and body composition are important contributors to the health and the development of a healthy lifestyle among children and youth . The New South Wales Schools  Fitness and Physical Activity Survey , 1997 , was conducted to fill some of the gaps in our knowledge of these aspects of the lives of young people in New South Wales . The survey was conducted in February and March , 1997 and collected data on a r and omly-selected sample of students ( n = 5518 ) in Years 2 , 4 , 6 , 8 and 10 . Measures were taken on body composition ( height and weight , waist and hip girths , skinfolds ) , health-related fitness ( aerobic capacity , muscular strength , muscular endurance , flexibility ) , fundamental motor skills ( run , vertical jump , catch , overh and throw , foreh and strike and kick ) , self-reported physical activity , time spent in sedentary recreation , and physical education ( PE ) classes . The methods are described to assist in the development of surveys of other population s and to provoke debate relevant to the development and dissemination of st and ard approaches to monitoring the fitness , physical activity habits and body composition of Australian children and youth . Finally , we offer comments on some of the strengths and limitations of the methods employed 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 Objective To investigate the associations between body composition , cardiorespiratory and muscular fitness in relation to travel mode to school in children and adolescents . Method Children and adolescents from 40 elementary schools and 23 high schools representing all regions in Norway were invited to participate in the study . Anthropometry , cardiorespiratory and muscular fitness  were tested at the school location . Question naires were used in order to register mode of transport to school , age , gender and levels of leisure time physical activity . Results A total of 1694 ( i.e. 60 % of all invited participants ) children and adolescents at a mean age of 9.6 and 15.6 respectively ( SD = 0.4 for both groups ) were analyzed for associations with physical fitness variables . Males cycling to school had lower sum of skin folds than adolescents walking to school . Higher cardiorespiratory fitness in adolescents and male cyclists compared to walkers and passive commuters were observed . Among children , cycling and walking to school , higher isometric muscle endurance in the back extensors compared to passive commuters was observed . Conclusion Based on this national representative cross-sectional examination of r and omly selected children and adolescents there is evidence that active commuting , especially cycling , is associated with a favourable body composition and better cardiorespiratory and muscular fitness as compared to passive commuting 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 : OBJECT Increased importance on academic achievement has result ed in many school districts focusing on improved academic performance leading to reductions in physical education time . The purpose was to examine the effects of 45 minutes of daily physical education on the cognitive ability , fitness performance and body composition of African American elementary and middle school youth . METHODS Participants completing the informed consent in grade s 2nd to 8th were included in the study . A pre/posttest design was used with repeated measures analysis of variance . Experimental and control school participants were pretested on the  cognitive measures ( ie , Fluid Intelligence and Perceptual Speed ) and Fitnessgram ® physical fitness test items ( eg , aerobic capacity , muscular strength and muscular endurance , body composition ) in September 2009 and posttested in May 2010 . RESULTS Experimental elementary and middle school participants observed significantly greater improvements compared with control elementary and middle school participants on 7 of 16 fitness and body composition measures and on 8 of 26 cognitive measures . These fitness , body composition , and cognitive improvement differences were more noticeable among elementary and middle school females . CONCLUSIONS Providing 45 minutes of daily physical education can perhaps increase cognitive ability while increasing fitness and decreasing the prevalence of overweight and obese youth Background Declining levels of physical fitness in children are linked to an increased risk of developing poor physical and mental health .  Physical activity programs for children that involve regular high intensity physical activity , along with muscle and bone strengthening activities , have been identified by the World Health Organisation as a key strategy to reduce the escalating burden of ill health caused by non-communicable diseases . This paper reports the rationale and methods for a school-based intervention design ed to improve physical fitness and physical activity levels of Grade s 5 and 6 primary school children . Methods / Design Fit-4-Fun is an 8-week multi-component school-based health-related fitness education intervention and will be evaluated using a group r and omized controlled trial . Primary schools from the Hunter Region in NSW , Australia , will be invited to participate in the program in 2011 with a target sample size of 128 primary schools children ( age 10 - 13 ) . The Fit-4-Fun program is theoretically grounded and will be implemented applying the Health Promoting Schools framework . Students will participate in weekly curriculum-based health and physical education lessons , daily break-time physical activities during recess and lunch , and will complete an 8-week ( 3 × per week ) home activity program with their parents and /or family members . A battery of six health-related fitness assessment s , four days of pedometery-assessed physical activity and a question naire , will be administered at baseline , immediate post-intervention ( 2-months ) and at 6-months ( from baseline ) to determine intervention effects . Details of the method ological aspects of recruitment , inclusion criteria , r and omization , intervention program , assessment s , process evaluation and statistical analyses are described . Discussion The Fit-4-Fun program is an innovative school-based intervention targeting fitness improvements in primary school children . The program will involve a range of evidence -based behaviour change strategies to promote and support physical activity of adequate intensity , duration and type , needed to improve health-related fitness . Trial Registration NoAustralia and New Zeal and Clinical Trials Register ( ANZCTR ) : BACKGROUND Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group , a group organized by Cancer Care Ontario 's Program in Evidence -Based Care ( pebc ) . The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer , focusing on the benefits of specific types of exercise , recommendations about screening requirements for new referrals , and safety concerns . METHODS Consistent with the pebc 's st and ardized approach , a systematic search was conducted for existing guidelines , and systematic literature search es were performed in medline and embase for both systematic review s and primary literature . Content and methodology experts performed an internal review , which was followed by an external review by targeted experts and intended users . RESULTS The search identified three guidelines , eighteen systematic review s , and twenty-nine r and omized controlled trials with relevance to the topic . The present guideline provides recommendations for the duration , frequency , and intensity of exercise appropriate for people living with cancer . It also provides recommendations for pre-exercise assessment , safety concerns , and delivery models . CONCLUSIONS There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment , and that it does not cause harm . The present guideline is intended to support the Canadian Society for Exercise Physiology 's Canadian physical activity guidelines . The recommendations are intended for clinicians and institutions treating cancer patients in Ontario , and for policymakers and program planners involved in the delivery of exercise programs for cancer patients OBJECTIVE To analyze socioeconomic indicators , physical activity ( PA ) opportunities , and behavioral correlates of cardiorespiratory and muscular fitness among Brazilian boys and girls . METHODS A sample of 1555 adolescents was r and omly selected . Age- and sex-specific st and ard scores were calculated for each fitness component . RESULTS Among boys , head of household 's schooling , involvement in organized PA , meeting the PA recommendations , and computer/games use were associated with cardiorespiratory fitness . Involvement in organized PA and active time in Physical Education ( PE ) classes were predictors of muscular fitness . Among girls , active time in PE classes and TV watching were predictors of cardiorespiratory fitness . Meeting the PA recommendations was associated with muscular fitness . CONCLUSION PA variables and sedentary behaviors should be independently considered for physical fitness promotion in youth BACKGROUND A large proportion of children do not reach the recommended levels of physical activity for health . A quasiexperimental study with nonr and om assignment was performed to evaluate the effectiveness and feasibility of a school-based physical education intervention aim ed at increasing the levels of moderate-to-vigorous physical activity ( MVPA ) . METHODS Ten classes from 4 primary schools , including 241 children aged 8 to 10 years , were recruited . The experimental group ( n = 97 ) received 4 additional sessions/week of 60 minutes of MVPA for 8 months . The control group ( n = 135 ) continued their st and ard program ( 2 sessions of 50 minutes/week ) . Motor abilities ( st and ing long jump , h and grip strength , Harre circuit , sit and reach ) , physical fitness ( Yo-Yo Intermittent Recovery Level-1 ) , anthropometric measures ( body mass index , waist to height ratio ) , and self-efficacy ( Perceived Physical Ability Scale for Children ) were evaluated at baseline and after the intervention . RESULTS The experimental group significantly improved in the Harre circuit both in males ( P < .001 ) and females ( P < .01 ) , whereas physical fitness test improved only in males ( P < .001 ) . Males in the experimental group improved the perception of self-efficacy in coordinative abilities ( P = .017 ) . CONCLUSIONS The proposed school-based MVPA program showed effectiveness and feasibility . The differences observed by gender highlight the need to use different strategies to increase the involvement of all the participants The purpose of the study was to investigate the effects of a school-based prevention program on physical activity , fitness , and obesity . We performed a prospect i ve study in eight Bavarian primary schools ( n = 724 children , 8.4 ± 0.7 years ) r and omized one to one to either an  intervention school ( IS , n = 427 ) or a  control school ( CS , n = 297 ) . Children in IS attended 10 health-related lessons at school over a period of 1 year . Parents and teachers attended two and three educational health-related lessons , respectively , and also received 10 newsletters on health issues . Daily physical activity ( ≥ 60 min/day ) , physical fitness ( six-item test battery ) , and anthropometric data were obtained at baseline and after 1 year . Physical activity and physical fitness increased in IS , but it failed to reach significant intervention effects . Nevertheless , a reduction in waist circumference was observed for all children [ mean change 1.7 cm ; 95 % confidence interval ( CI ) 1.2 - 2.3 ; P < 0.001 ) . This effect was more pronounced in overweight children ( > 90th percentile , n = 99 , mean change 3.2 cm ; 95 % CI 1.5 - 4.8 ; P < 0.001 ) . This easily administered preventative program involving children , parents , and teachers revealed that a generalized approach increasing physical activity will even be favorable in a subgroup of obese children This study establishes the relationship between the compliance with the governmental physical activity guidelines ( at least a minimum of one hour of moderate to vigorous physical activity , MVPA , five times a week ) , health-related physical fitness and different health related lifestyle variables in a representative sample of Spanish children . Subjects were a representative group of scholars from five schools r and omly selected in Extremadura , a mainly rural region with a very low population density . Statistical analysis comprises a t-test to calculate physical fitness differences between groups , according to the compliance with the mentioned physical activity guidelines . A multinomial logistic regression coefficient is established to determine the differences between the better physical fitness status group (= percentile 75 ) and the poorer physical fitness status group (= percentile 25 ) for each fitness test and gender , body mass index , physical activity , Mediterranean diet index and population size . Main findings show that the compliance with physical activity guidelines result in a better h and grip strength in left h and ( p < 0.05 ) , leg strength ( p < 0.000 ) , speed-agility run ( p < 0.000 ) and 20 m endurance shuttle run ( p < 0.000 ) . Being a girl , being overweighed and living in an urban setting are associated with a lower physical fitness (= percentile 25 ) , whereas there is no relationship between diet quality and subjects ' performance in all physical fitness test evaluated . As a conclusion , this study emphasizes the need to promote an active lifestyle in which physical activity suppose a minimum of one hour of regular MVPA , at least five times a week , to achieve a healthy fitness status Northern Irel and has the highest incidence of coronary heart disease ( CHD ) in the world . The physical fitness , activity patterns , health knowledge , attitudes , and dietary habits of a r and om , stratified sample of 3211 Northern Irish children , comprising 1540 boys and 1671 girls , age range 11 - 18 years were examined . At all ages boys were significantly more active than girls . The most important finding was an appreciable decline in physical activity levels after the age of 14 years reaching extremely low levels in older girls . While 75 % of exercise taken was not related to school , physical education classes constituted the only exercise taken by one third of pupils . Girls had healthier nutritional habits and were more inclined to employ weight control measures than boys . There was a preponderance of children with a higher body mass index indicating a tendency to obesity in the child population . Over 20 % of school leavers of both sexes regularly smoked cigarettes and 20 % regularly drank alcohol . The postulated relationship between childhood inactivity , adult sedentary lifestyle , and increased risk of CHD raises serious cause for concern regarding the future cardiovascular health of many children Objective . To assess the effectiveness of interventions that focus on reducing  sedentary behavior ( SB ) among school-age youth and to identify elements associated with interventions ' potential for translation into practice setting s. Methods . A comprehensive literature search was conducted using 4 data bases for peer- review ed studies published between 1980 and April 2011 . R and omized trials , which lasted at least 12 weeks , aim ed at decreasing  SB among children aged 6 to 19 years were identified . Results . Twelve studies were included ; 3 focused only on SB , 1 focused on  physical activity ( PA )  , 6 were combined SB and PA interventions , and 2 studies targeted SB , PA , and diet .  The majority of the studies were conducted in a school setting , while others were conducted in such setting s as clinics , community centers , and libraries . Conclusions . Overall , interventions that focused on decreasing SB were associated with reduction in time spent on SB and /or improvements in anthropometric measurements related to childhood obesity . Several of the studies did consider elements related to the intervention 's potential for translation into practice setting Background Physical activity ( PA ) is important for controlling childhood obesity , but a comprehensive PA model for school-aged children is lacking . Objectives Guided by the youth PA promotion ( YPAP ) model , this study estimated the direct and indirect effects of self-efficacy , enjoyment , parental influence , and environment on self-reported PA  and pedometer steps . A secondary purpose was to explore the association between self-reported PA and pedometer steps . Methods An observational and prospect i ve study was conducted among 133 children , aged 8–11 years old , from 10 elementary schools with afterschool programs in a Midwestern U.S. school district from August through October 2013 .  PA was assessed by a 7-day recall scale and pedometers . Other variables were assessed by vali date d question naires . Results Approximately 65 ( 49 % ) children were overweight or obese — only 17 ( 13 % ) met national PA recommendations — and body mass index z-score was negatively correlated with pedometer steps ( r = −.18 p = .04 ) . A path analysis showed that self-efficacy had a direct effect on self-reported PA and pedometer steps , enjoyment had only a direct effect on self-reported PA , and parental influence had a direct effect on pedometer steps and an indirect effect on self-reported PA through self-efficacy and enjoyment . The association between self-reported PA and pedometer steps was not significant . Discussion Because this study only partially supports the YPAP model , studies with a larger sample size and longitudinal design are essential to further examine this model . The nonsignificant relationship of self-reported PA with pedometer steps may be due to the systematic error result ing from a common method artifact of self-report . Given the importance of parental influence , enjoyment , and self-efficacy , targeting these three determinants in future interventions to increase PA among children is recommended 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 PURPOSE Health interventions based on theory may be more effective than those that are not . This review of review s synthesizes all published r and omized controlled trial ( RCT ) meta-analytic evidence from the last decade to examine whether theory-based interventions were found to be associated with more effective  adult health behaviour change interventions . METHODS Systematic review s including meta-analyses were identified by search ing Medline , CINAHL , PsycINFO , and CDSR . A narrative synthesis was used to summarize and analyse the evidence . Only review s including RCTs of health behaviour change interventions with adults aged 18 + published from 2007 to 2017 were included . RESULTS Of 8,659 articles , nine systematic review s met inclusion criteria . The majority of review s ( n = 8) suggested no increased effectiveness for theory-based compared to non-theory-based interventions for effectiveness of outcomes relating to health behaviour . Less than half of the RCTs included in the review s reported the use of theory ( 85/183 ) . Two review s suggested interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Method ological and reporting issues limit the conclusions . CONCLUSIONS Theory-based interventions as currently operationalized in systematic review s were not found to be more effective than non-theory-based interventions . Method ological and reporting issues at study and review level may not reflect the true utility of theory use within health behaviour interventions . The promotion of theory use may benefit from using a multifaceted argument , rather than a narrow focus of increased effectiveness . Statement of contribution What is already known on this subject ? Theory use is regularly promoted by cl aim ing that it will lead to more effective behaviour change interventions . Theory use has been frequently linked to effectiveness within systematic review s of behaviour change interventions . The theory-effectiveness hypothesis has not been systematic ally examined at the systematic review level . What does this study add ? Theory use as operationalized by systematic review authors was not associated with increased effectiveness within systematic review s examining r and omized controlled trials of behaviour change interventions in adults . Interventions based on control theory , motivational interviewing , or self-determination theory were associated with greater effectiveness for physical activity and /or dietary interventions and outcomes . Theory use should be promoted using a multifaceted argument , and assertions for increased effectiveness of theory-based interventions should only be used in domains where specific evidence exists to support this cl aim Background School-based intervention studies promoting a healthy lifestyle have shown favorable immediate health effects . However , there is a striking paucity on long-term follow-ups . The aim of this study was therefore to assess the 3 yr-follow-up of a cluster-r and omized controlled school-based physical activity program over nine month with beneficial immediate effects on body fat , aerobic fitness and physical activity . Methods and Findings Initially , 28 classes from 15 elementary schools in Switzerl and were grouped into an intervention ( 16 classes from 9 schools , n = 297 children ) and a control arm ( 12 classes from 6 schools , n = 205 children ) after stratification for grade ( 1st and 5th grade rs ) . Three years after the end of the multi-component physical activity program of nine months including daily physical education ( i.e. two additional lessons per week on top of three regular lessons ) , short physical activity breaks during academic lessons , and daily physical activity homework , 289 ( 58 % ) participated in the follow-up . Primary outcome measures included body fat ( sum of four skinfolds ) , aerobic fitness ( shuttle run test ) , physical activity ( accelerometry ) , and quality of life ( question naires ) . After adjustment for grade , gender , baseline value and clustering within classes , children in the intervention arm compared with controls had a significantly higher average level of aerobic fitness at follow-up ( 0.373 z-score units [ 95%-CI : 0.157 to 0.59 , p = 0.001 ] corresponding to a shift from the 50th to the 65th percentile between baseline and follow-up ) , while the immediate beneficial effects on the other primary outcomes were not sustained . Conclusions Apart from aerobic fitness , beneficial effects seen after one year were not maintained when the intervention was stopped . A continuous intervention seems necessary to maintain overall beneficial health effects as reached at the end of the intervention . Trial Registration ControlledTrials.com IS RCT BACKGROUND Obesity is now the most common chronic pediatric disease . Early health education programs could serve to prevent and treat childhood obesity and its numerous complications . AIM To examine the effects of a r and omized prospect i ve school-based intervention on anthropometric measures , body composition , leisure time habits and fitness in preschool children . CHILDREN Fifty-four preschool children completed a 14-week combined dietary-behavioral-physical activity intervention and were compared to 47 age matched controls ( age 5 - 6 yr ) . RESULTS Daily physical activity was significantly greater in the intervention group compared to the controls ( 6,927 + /- 364 vs 5,489 + /- 284 steps/ day , respectively ; p < 0.003 ) . Favorable changes were observed in weight ( 0.35 + /- 0.08 vs 0.9 + /- 0.1 kg , p < 0.0005 ) , BMI percentile ( -3.8 + /- 1.3 vs 2.9 + /- 1.5 kg/m2 , p < 0.001 ) , fat percent ( by skinfolds , -0.65 + /- 0.3 vs 1.64 + /- 0.3 % , p < 0.028 ) and fitness ( endurance time -3.55 + /- 1.85 vs 3.16 + /- 2.05 % , p < 0.017 ) in the intervention versus control groups . CONCLUSIONS A preschool , dietary/physical activity intervention may play a role in health promotion , prevention and treatment of childhood obesity OBJECTIVE To evaluate the impact of a multi-component school-based physical activity intervention ( Fit-4-Fun ) on health-related fitness and objective ly measured physical activity in primary school children . METHODS Four Hunter primary schools were recruited in April , 2011 and r and omized by school into treatment or control conditions . Participants included 213 children ( mean age = 10.72 years ± 0.6 ; 52.2 % female ) with the treatment group ( n = 118 ) completing the 8-week Fit-4-Fun Program . Participants were assessed at baseline and 6-month follow-up , with a 91 % retention rate . Cardio-respiratory fitness ( CRF ) ( 20 m shuttle run ) was the primary outcome , and secondary outcomes included body composition ( BMI , BMI ( Z ) ) , muscular fitness ( 7-stage sit-up test , push-up test , basketball throw test , St and ing Jump ) , flexibility ( sit and reach ) and physical activity ( 7 days pedometry ) . RESULTS After 6-months , significant treatment effects were found for CRF ( adjusted mean difference , 1.14 levels , p < 0.001 ) , body composition ( BMI mean , -0.96 kg/m(2 ) , p < 0.001 and BMI z-score mean -0.47 z-scores , p < 0.001 ) , flexibility ( sit and reach mean , 1.52 cm , p = 0.0013 ) , muscular fitness ( sit-ups ) ( mean 0.62 stages , p = 0.003 ) and physical activity ( mean , 3253 steps/day , p < 0.001 ) . There were no group by time effects for the other muscular fitness measures . CONCLUSIONS A primary school-based intervention focusing on fitness education significantly improved health-related fitness and physical activity levels in children Health benefits of physical activity  in children are well known . However , a drawback is the risk of physical activity-related injuries . Children are at particular risk for these injuries , because of a high level of exposure . Because of the high prevalence of physical activity injuries and the negative short- and long-term consequences , prevention of these injuries in children is important . This article describes how we systematic ally developed a school-based physical activity injury prevention programme using the intervention mapping ( IM ) protocol .IM describes a process for developing theory- and evidence -based health promotion programmes . The development can be described in six steps : ( i ) perform a needs assessment ; ( ii ) identify programme and performance objectives ; ( iii ) select methods and strategies ; ( iv ) develop programme ; ( v ) adopt and implement ; and ( vi ) evaluate . First , the results of the needs assessment showed the injury problem in children and the different risk factors for physical activity injuries . Based on the results of the needs assessment the main focus of the injury prevention programme was described . Second , the overall programme objective of the injury prevention programme was defined as reducing the incidence of lower extremity physical activity injuries . Third , theoretical methods and practical strategies were selected to accomplish a decrease in injury incidence . The theoretical methods used were active learning , providing cues and scenariobased risk information , and active processing of information . The practical strategy of the injury prevention programme was an 8-month course about injury prevention to be used in physical education classes in primary schools . Fourth , programme material s that were used in the injury prevention programme were developed , including newsletters for children and parents , posters , exercises to improve motor fitness , and an information website . Fifth , an implementation plan was design ed in order to ensure that the prevention programme would be implemented , adopted and sustained over time . Finally , an evaluation plan was design ed . The injury prevention programme is being evaluated in a cluster r and omized controlled trial with more than 2200 children from 40 primary schools throughout the Netherl and s . The IM process is a useful process for developing an injury prevention programme . Based on the steps of the IM we developed an 8-month injury prevention programme to be used in physical education classes of primary schools Background Recent data show that only 15 % of Australian adolescents participate in adequate amounts of physical activity ( PA ) and those students from Asian and Middle-Eastern background s in Grade s 6–12 are significantly less active than their English-speaking background peers . Schools have recently been recognised as the most widely used and cost-effective setting for promoting PA among youth and one domain within schools where PA can occur regularly for all youth , regardless of cultural background or socio-economic status , is during physical education ( PE ) . Methods This study describes changes in physical activity ( PA ) , lesson context and teacher interaction in physical education over the first two years in culturally and linguistically diverse secondary schools . Grade 7 PE classes in six schools were r and omly observed using systematic direct observation ( n = 81 ) and then followed up over the same period ( n = 51 ) twelve months later . Results There was no significant decline in moderate-to-vigorous physical activity ( MVPA ) during PE ( MD = −4.8 % ; p = .777 ) , but a significant decline and medium negative effect in time spent in vigorous physical activity ( VPA ) ( MD = −7.9 % ; p = .009 ) during PE was observed . Significant declines and large negative effects over time in percentage of PE time spent in management ( MD = −8.8 % ; p < .001 ) and the number of observations where teachers promoted  PA ( MD = −20.7 % ; p < .001 ) . Conclusions The decline of VPA and teacher promotion of PA in culturally and linguistically diverse schools is of concern . Given the declines in VPA and the increases in time spent in game play , further research is needed to ascertain whether PE instruction could be improved by focussing on skill instruction and fitness in a games-based PE instruction model . Further research for increasing teacher promotion of PA during PE is needed OBJECTIVE The primary purpose of this study was to determine whether multisystemic therapy ( MST ) , modified for use with youths presenting psychiatric emergencies , can serve as a clinical ly viable alternative to inpatient psychiatric hospitalization . METHOD One hundred sixteen children and adolescents approved for emergency psychiatric hospitalization were r and omly assigned to home-based MST or inpatient hospitalization . Assessment s examining symptomatology , antisocial behavior , self-esteem , family relations , peer relations , school attendance , and consumer satisfaction were conducted at 3 times : within 24 hours of recruitment into the project , shortly after the hospitalized youth was released from the hospital ( 1 - 2 weeks after recruitment ) , and at the completion of MST home-based services ( average of 4 months postrecruitment ) . RESULTS  MST  was more effective than emergency hospitalization at decreasing youths ' externalizing symptoms and improving their family functioning and school attendance . Hospitalization was more effective than  MST  at improving youths ' self-esteem . Consumer satisfaction scores were higher in the MST condition . CONCLUSIONS The findings support the view that an intensive , well-specified , and empirically supported treatment model , with judicious access to placement , can effectively serve as a family- and community-based alternative to the emergency psychiatric hospitalization of children and adolescents Background Worldwide in 2000 , 10 % of children aged five to 17 years were reported as being overweight with an additional 2‐3 % being obese . Overweight and obesity in childhood can adversely impact on both physical and psychological health . The rise in the prevalence of childhood obesity is a complex issue but widely recognised contributors include increased energy intake , decreased levels of physical activity and greater time spent in sedentary pursuits . A large number of environmental and cultural factors have also been identified as contributing to the problem . Evidence to support an optimal approach to treating childhood obesity is limited with many studies showing only modest results at best in the long‐term . However , the importance of family‐based treatment that combines diet , physical activity and behavioral components has been acknowledged in a recent Cochrane Systematic Review . It has also been suggested that interventions offered in the community setting may help overcome barriers to participation , by making programs more accessible and allowing the targeting of specific sub‐groups of the population . Objectives The objective of this review was to identify the effectiveness of parent‐centred interventions implemented in the community setting in modifying eating and physical activity behaviors or weight‐related outcomes of children . Inclusion criteria Types of participants This review considered studies that included free‐living children of pre‐school , primary and secondary school age and /or their parents/guardians aged > 18 years . Types of intervention(s)/phenomena of interest Intervention programs were required to have a parental component , to target eating and /or exercise behaviors for the prevention or treatment of obesity , and child weight status reported . Types of studies All intervention studies were included in the review including : r and omized controlled trials ( RCTs ) ; non‐r and omized controlled trials , longitudinal studies , cohort ( both retrospective and prospect i ve ) , case control and time series studies which had been conducted in a community setting . Types of outcomes This review considered studies that included overweight/obesity related outcomes , eating behavior outcomes , physical activity behaviour outcomes , and sedentary behavior outcomes and constructs . Search strategy A literature search of community‐based parent‐centred intervention studies to promote nutrition and physical activity for the prevention and treatment and of childhood overweight and obesity was performed in eight electronic data bases dating from 1975 to April 2009 . Method ological quality Studies were critically appraised for method ological quality using st and ardized tools . Data collection Data was extracted by one review er using a st and ardized data extraction form developed by the research ers and checked for accuracy and consistency by a second review er . Data synthesis Data in relation to setting , methodology , intervention components and effect on weight , dietary intake and physical activity was extracted , and described in a narrative synthesis . Where possible a meta‐ analysis was undertaken . Results Of the home‐based interventions , five of nine studies reported statistically significant changes in anthropometric outcomes post intervention . Of the 10 studies in the before and after school care setting , seven reported a significant decrease in a weight‐related outcome post intervention , with only one reporting an increase . Conclusions Results from the review support the after‐school setting as the most promising for community intervention setting for targeting parents as agents of change within child obesity prevention and treatment programs . Implication s for practice At this stage , interventions to support parents should target the after‐school environment as opposed to being conducted in the home , summer camps , leisure centers or churches . Targeting a decrease in energy intake and sweetened beverages in parallel with increasing number of daily steps and decreasing screen time use . Implication s for research Future studies of high quality are needed across the full range of community setting s. Given that currently most of the higher quality RCTs and the studies showing positive impacts of weight change are in the after‐school setting , further studies in this area using similar method ologies to those already published will facilitate future meta‐analyses in this area Many underserved school-age children do not meet the recommended guidelines for physical activity . While children ultimately depend on parents , they also look to schools for their access to developmentally appropriate physical activity . The present r and omized controlled trial study utilized a community – academic partnered participatory research approach to evaluate the impact of a culturally sensitive , comprehensive , school-based , program , Kids N Fitness © , on body mass index ( BMI ) , and child physical activity behavior , including : daily physical activity , team sports participation , attending PE class , and TV viewing/computer game playing  , among underserved children ages 8–12 ( N = 251 ) in Los Angeles County . All measures were collected at baseline , 4 and 12 months post-intervention . Students who participated in the KNF program had significant decreases in BMI Z-score , TV viewing , and an increase in PE class attendance from baseline to the 12 month follow-up . Our study shows the value of utilizing community – academic partnerships and a culturally sensitive , multi-component , collaborative intervention OBJECTIVE To prospect ively examine the effects of a r and omized school-based intervention on nutrition and physical activity knowledge and preferences , anthropometric measures , and fitness in low socioeconomic kindergarten children . STUDY DESIGN A total of 376 children completed a school-year combined dietary-behavioral-physical activity intervention  and were compared with 349 control subjects ( age 3.8 to 6.8 years ) . RESULTS The prevalence of overweight and obesity among the kindergarten children was 27.7 % . Even though the intervention was not associated with between group differences in body mass index changes , it was associated with significantly ( P < .05 ) greater increase in nutrition knowledge and preferences , physical activity knowledge and preferences , and improvement in fitness . There was a greater ( P < .05 ) decrease in the number of overweight children in the intervention group ( -31.9 % ) compared with the controls ( -17.5 % ) . CONCLUSIONS A kindergarten dietary-physical activity intervention applied by the kindergarten teachers , had no effect on body mass index changes between the groups , but improved nutrition and physical activity knowledge and preferences , improved fitness , and decreased the percent of overweight children . This intervention may play an important role in health promotion , prevention and treatment of childhood obesity
Results Physical activity was associated with numerous health benefits .
The dose-response relations observed in observational studies indicate that the more physical activity , the greater the health benefit .
Results from experimental studies indicate that even modest amounts of physical activity can have health benefits in high-risk youngsters ( e.g. , obese ) .
Vigorous intensity activities may provide even greater benefit .
Aerobic-based activities had the greatest health benefit , other than for bone health , in which case high-impact weight bearing activities were required .
Some of the health benefits can be achieved through an average of 30 minutes per day . [
Level 2 , Grade A ] .
Background The purpose was to : 1 ) perform a systematic review of studies examining the relation between physical activity , fitness , and health in school-aged children and youth , and 2 ) make recommendations based on the findings .