Rethinking children’s physical activity interventions at school : A new context-specific approach
Jago, R., Salway, R., House, D., Beets, M., Lubans, D. R., Woods, C., & de Vocht, F. (2023). Rethinking children’s physical activity interventions at school : A new context-specific approach. Frontiers in Public Health, 11, Article 1149883. https://doi.org/10.3389/fpubh.2023.1149883
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2023Copyright
© 2023 Jago, Salway, House, Beets, Lubans, Woods and de Vocht.
Physical activity is important for children’s health. However, evidence suggests that many children and adults do not meet international physical activity recommendations. Current school-based interventions have had limited effect on physical activity and alternative approaches are needed. Context, which includes school setting, ethos, staff, and sociodemographic factors, is a key and largely ignored contributing factor to school-based physical activity intervention effectiveness, impacting in several interacting ways.
Conceptualization: Current programs focus on tightly-constructed content that ignores the context in which the program will be delivered, thereby limiting effectiveness. We propose a move away from uniform interventions that maximize internal validity toward a flexible approach that enables schools to tailor content to their specific context.
Evaluation designs: Evaluation of context-specific interventions should explicitly consider context. This is challenging in cluster randomized controlled trial designs. Thus, alternative designs such as natural experiment and stepped-wedge designs warrant further consideration.
Primary outcome: A collective focus on average minutes of moderate-to-vigorous intensity physical activity may not always be the most appropriate choice. A wider range of outcomes may improve children’s physical activity and health in the long-term. In this paper, we argue that greater consideration of school context is key in the design and analysis of school-based physical activity interventions and may help overcome existing limitations in the design of effective interventions and thus progress the field. While this focus on context-specific interventions and evaluation is untested, we hope to stimulate debate of the key issues to improve future physical activity intervention development and implementation.
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This project is funded by UKRI REF EP/X023508/1. RJ and FdV are partly funded by the by the National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West). RJ is partly supported by the National Institute for Health and Care Research Bristol Biomedical Research Centre (Bristol BRC). DL is funded a National Health and Medical Research Council Senior Research Fellowship (APP1154507). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of any funder. Funders were not involved in data analysis, data interpretation, or writing of the paper. ...License
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