Are There Effective Interventions to Increase Physical Activity in Children and Young People? An Umbrella Review

Background: Obesity and physical inactivity among children and young people are public health concerns. While numerous interventions to promote physical activity are available, little is known about the most effective ones. This study aimed to summarize the existing evidence on interventions that aim to increase physical activity. Methods: A systematic review of reviews was conducted. Systematic reviews and meta-analyses published from January 2010 until November 2017 were identified through PubMed, Scopus and the Cochrane Library. Two reviewers independently assessed titles and abstracts, performed data extraction and quality assessment. Outcomes as level of physical activity and body mass index were collected in order to assess the efficacy of interventions. Results: A total 30 studies examining physical activity interventions met the inclusion criteria, 15 systematic reviews and 15 meta-analyses. Most studies (N = 20) were implemented in the school setting, three were developed in preschool and childcare settings, two in the family context, five in the community setting and one miscellaneous context. Results showed that eight meta-analyses obtained a small increase in physical activity level, out of which five were conducted in the school, two in the family and one in the community setting. Most promising programs had the following characteristics: included physical activity in the school curriculum, were long-term interventions, involved teachers and had the support of families. Conclusion: The majority of interventions to promote physical activity in children and young people were implemented in the school setting and were multicomponent. Further research is needed to investigate nonschool programs.

Intevention to promote PA in after school PA (accellerometer or self-report) <18 years / Of the nine studies meeting inclusion criteria, three reported an increase or smaller decrease in physical activity amongst intervention participants compared with controls and six indicated no change. Evidence suggests that single-behaviour interventions may be most effective during these hours.
Overall, findings indicate that interventions to promote physical activity delivered in the after-school setting have been ineffective to date School-based interventions with combined diet and physical activity components and a home element had greatest effectiveness; evidence in support of the effect of preschool-based (n=6), community-based (n=7), and home-based (n=2) interventions was limited by a paucity of studies and heterogeneity in study design Community setting and miscellaneous Camacho-Miñano, 2011 Interventions to promote physical activity among young and adolescent girls: A systematic review Six studies reporting on physical activity levels were found to have medium-tolarge effect sizes. All 4 studies reporting learning outcomes showed positive effects of intervention lessons. Teachers and students were pleased with the programs, and enhanced on-task behavior was identified (n = 3). Positive effects were also reported on students' body mass index levels (n = 3).

School
McIntosh ,  The pooled effects were small and non-significant for both total physical activity SMD = 0.02 95% CI (-0.13 to 0.18) and for moderate-to-vigorous physical activity SDM = 0.24 95% CI (-0.08 to 0.56). Sample age and accelerometer compliance were significant moderators for total physical activity, with a younger sample and higher compliance associated with larger effects.

School Brown HE, 2016
Family-based interventions to increase physical activity in children: a systematic review, metaanalysis and realist synthesis RCTs, C-RCTs, pilot studies 47 Intervention to increase physical activity by actively engaging the family Self-reported PA.
5-12 years up to 6 months to 12 months or longer The meta-analysis (19 studies) demonstrated a significant small effect in favour of the experimental group SMD=0.41 95% CI (0.15 to 0.67). Sensitivity analysis, removing one outlier, reduced this to SMD= 0.29 95% CI (0.14 to 0.45). The qualitative synthesis showed that in the context of family constraints (such as time or scheduling difficulties), a combination of goal-setting and reinforcement intervention strategies was effective in changing physical activity behaviour, through the mechanism of increased motivation. Children and adolescents exposed to the intervention spent less time watching television (results range from five to 60 min less per day), and had improved VO2max (results across studies ranged from 1.6 to 3.7 mL/kg per min)

-18 years /
All of the included studies reported a higher proportion of active learning time in the intervention group compared with the control group; most of these differences were reported as being statistically significant. The meta-analysis revealed an absolute difference of 10.37% CI (6.33 to 14.41) of lesson time spent in MPVA in favour of the intervention over controls. The 10.37% difference related to 24% more active learning time in the intervention groups than in the control groups SMD= 0.62, 95% CI (0.39 to 0.84).

Mei, 2016
The impact of long-term schoolbased physical activity interventions on body mass index of primary school children -a metaanalysis of randomized controlled trials Classroom-based physical activity PA 5-12 years Until 3 years The meta-analyses showed classroom-based physical activity had a positive effect on improving on-task and reducing off-task classroom behaviour OR=0.60, 95% CI (0.20 to 1.00), and led to improvements in academic achievement SMD = 1.03, 95% CI (0.22,1.84). However, no effect was found for cognitive functions SMD = 0.33, 95% CI (-0.11,0.77)