Date of Award

12-2024

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Jai K. Das

Second Advisor

Dr. Zohra Lassi

Third Advisor

Dr. Kanza Naqvi

Department

Community Health Sciences

Abstract

Background: Physical inactivity among adolescents is increasingly a challenge contributing to the rising cases of noncommunicable diseases, obesity, and mental health problems. Schools provide a perfect setting through which physical activity can be promoted, particularly in low- and middle-income countries (LMICs) where access of exercise facilities might be limited. This review addresses the effect of school-based interventions on adolescent physical activity, fitness, sedentary behaviors, and body mass index.
Objective: To assess the effect of interventions to promote physical activity among adolescents (10-19 years) in school settings
Method: This systematic review follows PRISMA 2020 guidelines and two independent reviewers assessed studies on the specified inclusion criteria: This review included randomized controlled trials (RCTs—both individual and cluster). The included studies for the review focused on school-based interventions targeting adolescents aged between 10–19 years to promote physical activity or reducing sedentary time. The outcome measurements were levels of physical activity, fitness, sedentary time, and BMI.
Results: The search from multiple databases (PubMed, CINAHL, Wiley Cochrane Library, Embase and Scopus) identified 30,629 records, from which 90 studies were included after rigorous screening. The interventions varied widely, such as multicomponent programs, physical education classes, and after-school activities. The studies were conducted across high-income countries (HICs), with limited representation from lower-middle-income countries (LMICs). The meta-analysis demonstrated a statistically significant improvement in physical fitness, specifically in VO2 max, with a standardized mean difference (SMD) of 0.38 (95% CI: 0.19 to 0.57) achieved through multi-component programs at 0–6 months of follow-up. However, this improvement diminished over longer durations. The effect on moderate-tovigorous physical activity (MVPA) was negligible (SMD 0.02, 95% CI: -0.06 to 0.11), while reductions in sedentary behavior were also comparable (SMD -0.06, 95% CI: - 0.12 to 0.01). The impact on BMI was not statistically significant, with considerable heterogeneity observed across studies.
Conclusion: School-based programs provide a good starting point for promoting physical activity and fitness among adolescents, but their effects on BMI and sedentary behavior are limited. A more holistic approach, involving not only schools but also families and communities, may help sustain these health improvements. Future research should explore how to design interventions suited to LMICs and assess their long-term impact on adolescent health.

First Page

1

Last Page

276

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