Systematic Review and Meta-Analysis of Multi-Component Interventions Through Schools to Increase Physical Activity

Background: A "whole-of-school" approach is nationally endorsed to increase youth physical activity (PA). Aligned with this approach, comprehensive school physical activity programs (CSPAP) are recommended. Distinct components of a CSPAP include physical education (PE), PA during the school day (PADS), PA before/after school (PABAS), staff wellness (SW), and family/community engagement (FCE). The effectiveness of interventions incorporating multiple CSPAP components is unclear. A systematic review and meta-analysis were conducted examining the effectiveness of multicomponent interventions on youth total daily PA. Methods: Electronic databases were searched for published studies that (1) occurred in the US; (2) targeted K-12 (5-18 years old); (3) were interventions; (4) reflected 2 CSPAP components, with at least 1 targeting school-based PA during school hours; and (5) reported outcomes as daily PA improvements. Standardized mean effects (Hedge's g) from pooled random effects inverse-variance models were estimated. Results: Across 14 studies, 12 included PE, 5 PADS, 1 PABAS, 2 SW, and 14 FCE. No studies included all 5 CSPAP components. Overall, intervention impact was small (0.11, 95% CI 0.03-0.19). Conclusions: As designed, there is limited evidence of the effectiveness of multicomponent interventions to increase youth total daily PA. Increased alignment with CSPAP recommendations may improve intervention effectiveness.