Do socioeconomic inequities arise during school-based physical activity interventions? An exploratory case study of the GoActive trial

Social inequalities in the effects of school-based well-being interventions: a systematic review

Rising public concern about comprehensive child and adolescent well-being has led to the development of school-based interventions with the potential for high-reaching and effective support. While some interventions have shown effectiveness, limited understanding exists regarding how social inequalities are considered and evidenced in such interventions. This study examines how social inequalities are considered in universal school-based interventions and their potential to affect inequalities through differential effects. A systematic review following the PRISMA protocol was conducted using the following databases: PubMed, Web of Science, CINAHL, Scopus, ProQuest and APA PsycArticles. Studies published between 2014 and 2023 were included. Screening and data extraction were conducted independently by two researchers. Of 10 028 initial articles, 44 were included in the final analysis. These studies primarily involved physical activity and mindfulness interventions in schools. Despite many studies including information regarding students' social backgrounds, such as socioeconomic position and immigrant background, the analysis of differential intervention effects among demographic groups was limited and mostly based on sex. Most differential effect analyses showed no significant differences based on social background, and no clear differences were found based on intervention type. While some universal school-based interventions show promise in reducing social inequalities in students' well-being, more empirical research is needed to explicitly target these questions. This review highlights the critical need for comprehensive intervention studies to consider and report relevant dimensions of social background and their interactions with intervention effects.

TRIAL REGISTRATION

PROSPERO; registration no. CRD42023423448.

School-based physical activity interventions: which intervention characteristics are associated with participation and retention? A meta-analysis

OBJECTIVE

Many school-based intervention studies are conducted to increase students' physical activity (PA). Recruitment and retention problems potentially impact the robustness of RCT findings. We conducted a meta-analysis to summarize recruitment and retention rates in long-term secondary school-based PA intervention studies and examined associated participant and intervention characteristics.

METHODS

Web of Science, Pubmed, Medline, and PsychInfo were searched until March 20th 2023. We included studies on secondary school-based PA interventions ≥12 weeks, aimed at typically developing adolescents. We abstracted number of schools and students invited, randomized, and participating at follow-up to calculate pooled recruitment and retention rates; participant and intervention characteristics were abstracted to execute subgroup or meta-regression analyses.

RESULTS

Recruitment rates were 51% for invited schools and 80% for invited students, the retention for schools was almost 100% and for students 91%. Interventions with fixed and flexible components, executed in Asia and South America, and from later publication years had higher student recruitment rates. Students' retention rates were lower for interventions which had flexible components, were theory/model-based, used an accelerometer, had a longer intervention duration, and included more females.

CONCLUSION

Recruitment and retention rates in school-based PA interventions are high. Some participant and intervention characteristics influence these rates: flexibility of the intervention, theory/model-based intervention, accelerometer use, intervention duration, continent, and number of females. Researchers should consider these characteristics in intervention development to achieve optimal balance between intervention effectiveness, recruitment, and retention.