Thesis
Moderate to vigorous intensity physical activity during school hours in primary school children
- Creator
- Rights statement
- Awarding institution
- University of Strathclyde
- Date of award
- 2024
- Thesis identifier
- T17162
- Person Identifier (Local)
- 201967777
- Qualification Level
- Qualification Name
- Department, School or Faculty
- Abstract
- Background: Physical inactivity is a global challenge that needs to be addressed urgently. Schools can make a significant impact on children’s current and future physical activity behaviour as children spend more time in school than anywhere other than home. Sustainable school-based physical activity strategies are necessary to offer an active school day for large numbers of children with suitable interventions starting as early as possible to promote a long and healthy lifestyle. This thesis aims to evaluate and explore school-based strategies to increase pupils’ moderate-to-vigorous physical activity (MVPA) levels during school hours (through physical education, recess, and other domains of physical activity in school). The secondary aim is to provide recommendations and a clearer insight into the issues of school based MVPA. Methods: The thesis is based on the findings of four studies. The first is a systematic review of interventions to increase moderate-to-vigorous physical activity (MVPA) levels in physical education (PE) lessons for primary school children. The review was an update of Lonsdale et al.'s 2013 review. The update was necessary because the previous review was 10 years old, and the studies it included were mainly conducted in the USA, focusing on primary and secondary education levels. Research is a constantly evolving field, so more recent studies are likely to be available. Updating the review was useful, as it produced new evidence that was not included in Lonsdale et al.'s original review. This new evidence was relevant and applicable to Scotland, providing a solid basis for the thesis. The second study is a protocol paper developed by adapting an existing intervention to a Scottish context, the aim of this study is to determine whether the strategies employed in England could be adopted in Scotland. The third and fourth studies are based on a large nationally representative sample provided by the SPACES (Studying Physical Activity in Children’s Environments across Scotland) study conducted between May 2015 and May 2016. There were 774 children (417 females, 357 males), aged 10/11 years, randomly chosen from 471 schools, who took part. The SPACES study, with data collected inclusively during school hours and recess time across five weekdays, formed the basis for analyses in 2022. The third study looks at the MVPA levels accrued during a normal school day and risk factors including gender, socioeconomic status (SES), season, and urban or rural residency are investigated. The fourth study examines children’s MVPA levels during recess time with the same risk factors plus an extra one, namely, the length of the recess. Mean time spent in MVPA during school hours and recess is computed and compared against a recommendation that children should achieve 30 minutes of MVPA during school hours and 40% of recess time should be in MVPA. Binary logistic regression, presented as odds ratio (O.R.) and confidence intervals (C.I.), analyses explored associations between meeting/not meeting the recommendation by the candidate risk factors. Key findings and implications from the four studies are summarised and recommendations for schools on engaging pupils more in MVPA during school hours are also provided. Results: The systematic review (Study 1) identified only five studies from a total of 5459 records over the period from 2010 to 2019. All eligible studies reported favourable intervention effects. Meta-analysis was possible from 4/5 studies: The mean difference between intervention and control groups at follow-up was +14.3% of lesson time in MVPA (confidence interval (CI 2.7 to 25.8)). One apparently highly effective intervention, the SHARP Principles Model, was identified as it increased children’s MVPA during PE lessons by 30% and 27% respectively when tested twice across multiple schools in England. A protocol paper (Study 2) was employed to translate the SHARP intervention for use in Scotland (SHARP Scotland). However, circumstances made the implementation not feasible due to COVID lockdowns during the time frame. This paper was proposed as the foundation and provided insight for a fully powered effectiveness trial in the future. The results of device-based measured accelerometry data (from Studies 3 and 4) showed that children’s MVPA levels during school hours (an average of 29 minutes) and recess (3.2 out of 16.1 minutes) were very low. Only 43% of children during school hours and 6% during recess met the relevant MVPA recommendations. Gender was a significant factor in meeting the MVPA recommendations, with 33% of girls vs 54% of boys meeting the recommendations during school hours, and 1% of girls versus 11% of boys during recess. SES (socioeconomic status) was not a significant factor in meeting the MVPA recommendations during either school hours or recess. Among participants, 42% of those in the most deprived quintile met the school hours MVPA recommendation, compared to 39% in the least deprived quintile. During recess, 3.6% of those in the most deprived quintile met the recommendation, compared to 4.3% in the least deprived quintile. Seasons were a significant factor for achieving school hours MVPA, with 42% of participants meeting the recommendation in winter, 52% in spring, 59% in summer, and 34% in autumn. Urban versus rural residency was also a significant factor, with 40% of urban participants compared to 52% of rural participants meeting the school hours MVPA recommendation. Conclusions: Levels of MVPA during school hours and recess are very low in Scottish children included in the SPACES Study. Interventions to increase MVPA during PE are promising, and one particular intervention seemed especially promising. Any interventions run during PE lessons, recess, and other domains of physical activity in school should benefit all children.
- Advisor / supervisor
- Reilly, John
- Resource Type
- DOI
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