Flexible learning spaces reduce sedentary time in adolescents

Effectiveness of Intervention Strategies to Increase Adolescents' Physical Activity and Reduce Sedentary Time in Secondary School Settings, Including Factors Related to Implementation: A Systematic Review and Meta-Analysis

BACKGROUND

Globally, just one in five adolescents meet physical activity guidelines and three-quarters of the school day is spent sitting. It is unclear which types of school-based interventions strategies increase physical activity and reduce sedentary time among adolescents, or how these interventions are implemented influences their effectiveness.

OBJECTIVE

The three aims of our systematic review were to (a) identify intervention strategies used within secondary school settings to improve students' movement behaviours throughout school-based initiatives, delivered at or by the school; (b) determine the overall effect of the interventions (meta-analysis) on physical activity (all intensities), sedentary time, cognitive/academic, physical health and/or psychological outcomes; and (c) describe factors related to intervention implementation.

METHODS

Searches were conducted in MEDLINE complete, EMBASE, CINAHL, SPORTDiscus, APA PsycINFO, and ERIC in January 2023 for studies that (a) included high school-aged adolescents; (b) involved a school-based intervention to increase physical activity and/or decrease sedentary time; and (c) were published in English. Reported effects were pooled in meta-analyses where sufficient data were obtained.

RESULTS

Eighty-five articles, representing 61 interventions, met the inclusion criteria, with 23 unique intervention strategies used. Interventions that involved whole-school approaches (i.e., physical activity sessions, environmental modifications, teacher training, peer support and/or educational resources) were favourably associated with most of the outcomes. The meta-analyses showed: (a) non-significant effects for sedentary time (Standardized mean difference [SMD] = -0.02; 95%CI, -0.14, 0.11), physical activity at all intensities (light: SMD= -0.01; 95%CI, -0.08, 0.05; moderate: SMD = 0.06; 95%CI, -0.09, 0.22; vigorous: SMD = 0.08; 95%CI, -0.02, 0.18; moderate-to-vigorous: SMD = 0.05; 95%CI, -0.01, 0.12) and waist circumference (SMD = 0.09; 95%CI, -0.03, 0.21), and (b) a small statistically significant decrease in body mass index (SMD= -0.09, 95%CI -0.16, -0.0). Factors related to intervention implementation were reported in 51% of the articles.

CONCLUSION

While some intervention approaches demonstrated promise, small or null effects were found in meta-analyses. Future school-based interventions should utilize a whole-school approach designed to increase adolescents' activity across the day. Consistent reporting of implementation will increase understanding of how interventions are adopted, implemented and sustained.

REGISTRATION

PROSPERO (CRD42020169988).

Primary school learners' movement during class time: perceptions of educators in the Western Cape, South Africa

BACKGROUND

Over the last decade, the efficacy of in-classroom movement to reduce sedentary behaviour has been mainly conducted in high-income, developed countries. To date, there have been no published reports on the perceptions of principals and teachers regarding learners' movement during class time to inform the implementation of classroom-based movement strategies to reduce sedentariness in South Africa.

METHODS

A sample of primary school principals and grades 5 and 6 teachers from a range of socio-economic categories participated in this exploratory, descriptive qualitative study in the metro central district of the Western Cape Education Department in South Africa. Transcripts of individual depth interviews (IDIs) with principals and focus group discussions (FGDs) with teachers were coded using Atlast ti 9* software for qualitative analysis.

RESULTS

Thirteen principals (13 IDIs) and 24 teachers (6 FGDs) participated in the study. Two main factors influencing in-classroom movement, namely teacher-related and structural factors, were identified. The teacher-related factors pertained to their classroom management practice, knowledge and beliefs about sitting, and management style influenced their role in delivering the curriculum and creating a classroom environment conducive for learning. Classroom factors pertained to classroom size, the number of learners in the class and the ergonomic utility of traditional classroom desks. Institutional expectations and acceptance of learners' behaviour, and teachers' practice were also notable contributing factors that influenced learners' movement during class time.

CONCLUSION

Emerging evidence about the efficacy of in-classroom movement on sedentary behaviour and learning outcomes challenges traditional teacher practice that sitting is essential for the delivery of the curriculum and for creating an optimal learning environment. Teacher training about the behaviour control utility of in-classroom movement, and school management and policy supportive of in-classroom movement may encourage fidelity to in-classroom movement strategies.

Making 'being less sedentary feel normal' -investigating ways to reduce adolescent sedentary behaviour at school: a qualitative study

BACKGROUND

Adolescents spend over 50% of a 24-hour period and 63% of the school day sedentary. Few comprehensive qualitative studies have explored teachers' and students' perceptions of potential strategies to reduce sedentary behaviour (SB) in the secondary school setting. This project aimed to elicit students' and teachers' perspectives of feasible and acceptable ways to encourage adolescents to "sit less and stand or move more" during the school day.

METHODS

Students, teachers, and executives from four schools in the Illawarra and surrounding areas (New South Wales) Australia, were invited to participate. Focus group implementation used a participatory research design ('problem and solution tree'). Participants were interviewed in three groups, younger adolescents, older adolescents and teachers/executives. Firstly the 'problem' (high rates of SB) was explained, participants were then asked to identify contributing school related factors, and to suggest feasible ideas to reduce SB during the school day.

RESULTS

Fifty-five students (24 from Years 7/8 aged 12-14 years and 31 from Years 9/10 aged 14-16 years), and 31 teachers consented to participate. Thematic analysis elicited five main 'problems': lesson structure, non-conducive classroom environment/structure, non-conducive break-time environment, curricular pressures and school-related factors increasing sedentary behaviour outside of school. Suggested 'solutions' included: changes to classroom layout/furniture, pedagogical changes, hands-on learning, outdoor lessons, more comfortable uniforms, more breaks during class time, compulsory physical activity, and outdoor equipment.

CONCLUSIONS

The proposed solutions to reduce adolescent SB during the school day have potential to be feasibly implemented in the school setting, even with limited funding.

Sedentary Patterns and Sit-to-Stand Transitions in Open Learning Spaces and Conventional Classrooms among Primary School Students

Educational reforms worldwide have resulted in schools increasingly incorporating open and flexible classroom designs that may provide possibilities to reduce sedentary behavior among students during lessons. Cross-sectional associations of classroom type on accelerometry assessed sedentary bout durations and sit-to-stand transitions were investigated in 191 third and fifth grade students recruited from one school with open learning spaces and two schools with conventional classrooms. A three-way ANOVA for classroom type, gender and grade level indicated that students in open learning spaces had more 1-to-4-min sedentary bouts (mean difference 1.8 bouts/h, p < 0.001), fewer >10-min sedentary bouts (median 0.20 vs. 0.48 bouts/h, p = 0.004) and more sit-to-stand transitions (mean difference 0.9 STS/h, p = 0.009) than students in conventional learning spaces. Comparisons between schools by grade, which were conducted with a one-way ANCOVA adjusted for gender, indicated that most of the significant differences occurred between schools with different classroom types. There were only small and mostly statistically nonsignificant differences between the two schools with conventional classrooms. In conclusion, open learning spaces may improve children’s sedentary profiles towards shorter sedentary bout durations and facilitate also postural transitions during lessons, which may translate into beneficial health impacts over a longer period.

School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review

BACKGROUND

The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5-18 years) attending school.

METHODS

This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results.

RESULTS

Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries.

CONCLUSIONS

Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.

The Acute Effects of Standing on Executive Functioning in Vocational Education and Training Students: The Phit2Learn Study

Research suggests that sedentary behavior (SB) is negatively associated with cognitive outcomes. Interrupting prolonged sitting has been shown to improve cognitive functions, including executive functioning (EF), which is important for academic performance. No research has been conducted on the effect of standing on EF in VET students, who make up a large proportion of the adolescent population and who are known to sit more than other students of this age. In this study, we investigated the acute effects of reducing SB by short time standing on EF in vocational education and training (VET) students. In a randomized crossover study, 165 VET students were first taught for 15 min in seated position. After this, they performed while seated the Letter Memory Test for updating, and the Color Shape Test for shifting and inhibition. Students were randomly assigned to a sitting or standing condition. All students were taught again for 15 min and then took the same tests in the condition they were allocated to, respectively, standing or seated. After 1 week, the test procedure was repeated, in which students switched conditions. Mixed model analyses showed no significant effect of sitting or standing on updating, shifting, or inhibition. Also, no significant differences were found for the order of condition on updating, shifting, or inhibition. Our results suggest that 40 min of standing does not significantly influence EF among VET students.

Comparison of Classroom-Based Sedentary Time and Physical Activity in Conventional Classrooms and Open Learning Spaces Among Elementary School Students

European children and adolescents spend most of their daily life and especially their school hours being sedentary which may increase their risk for chronic non-communicable diseases later in life. After the curriculum reform of Finnish basic education in 2014, most of the new or renovated comprehensive schools in Finland incorporate open and flexible classroom designs. Their open learning spaces may provide students opportunities to reduce sedentary behavior during school hours. Thus, waist-worn accelerometers were used to assess classroom-based sedentary time (ST), the number of breaks from sedentary time (BST), and physical activity (PA) among cross-sectional samples of 3rd and 5th grade students during two separate academic years in a school that underwent a renovation from conventional classrooms to open learning spaces. The cohort of 5th grade students before renovation had a smaller proportion of ST from total classroom time (56.97 ± 12.24%, n = 42 vs. 67.68 ± 5.61%, n = 28, mean difference = 10.71%-points, 95%CI = −15.65 to−5.77, p < 0.001), a greater number of BST per 60 min of classroom time (7.41 ± 1.16 breaks/h vs. 9.19 ± 1.59 breaks/h, mean difference = −1.78 breaks/h, 95%CI = −2.486 to −1.079, p < 0.001) and a greater proportion of light intensity PA (28.66 ± 9.99% vs. 22.56 ± 4.59%, mean difference = 6.10%, 95%CI = 2.56 to 9.64, p = 0.001) than the 5th grade cohort assessed after renovation. The cohort of 3rd grade student had a greater proportion of moderate-to-vigorous intensity PA (MVPA) after the renovation compared to the cohort assessed before the renovation [Mean Rank (Before) = 27.22, Mean Rank (After) = 37.58, U =524.0, p = 0.033]. Despite the greater ST found in 5th graders, schools with open learning spaces may facilitate BST or MVPA as observed in the 5th and 3rd grade cohorts in open learning spaces compared to the cohorts in conventional classrooms, respectively. Future studies should seek to investigate and develop teacher practices to capitalize the potential of open classrooms to reduce ST, since classroom renovation alone may not be a sufficient intervention as of itself. Longitudinal studies utilizing randomized controlled trials are warranted.

School Flexible Learning Spaces, Student Movement Behavior and Educational Outcomes among Adolescents: A Mixed-Methods Systematic Review

BACKGROUND

To achieve sustainability, we must consider scalable improvements in student movement behavior in the classroom setting, educational priorities. Flexible learning spaces that employ student-centered pedagogy and contain a range of furniture and layout options, implemented to improve educational outcomes, may enable unintended health benefits. In this review, we summarize the evidence on the effects of flexible learning spaces on adolescent student movement behaviors and educational outcomes.

METHODS

We searched 5 databases, retrieving 5 quantitative and one qualitative article meeting the review criteria.

RESULTS

Students in flexible learning spaces spent less time sitting, and more time standing and moving. Students were also more engaged, on-task, and collaborated and interacted more. Academic results for English, Mathematics and Humanities for those in flexible learning spaces were higher than peers in traditional classrooms.

CONCLUSION

Evidence from the reviewed studies suggests that there may be beneficial outcomes across some movement behaviors as well as learning outcomes in classrooms that employ student-centered pedagogy and use a built environment that facilitates autonomy and choice around where and how to learn. These learning environments present an opportunity for an interdisciplinary approach to address sedentary behavior in classrooms.

Physical Activity Levels of Chilean Children in a National School Intervention Programme. A Quasi-Experimental Study

Background. Recess is a great opportunity to interrupt sedentary behaviour and increase moderate-to-vigorous physical activity (MVPA) in schoolchildren. This quasi-experimental study aimed to compare the levels of physical activity (PA) during the school day of children in a school intervention programme vs. those in a control group, and to determine compliance with MVPA recommendations. Methods. A sample of 154 schoolchildren (6–12 years old) was obtained from several schools (70 with the intervention and 84 controls). This programme was structured with a duration of 90 min/session and performed three times/week. PA levels were recorded with triaxial accelerometers during the school day: during recess, during a PA session or physical education session (PE), and during lunchtime. No pre-intervention evaluation was performed. Results. The MVPA of the control group was higher than that of the intervention group during the first recess (p < 0.001). None of the groups complied with the recommendations for steps during the PA or PE sessions. During the PA session, sedentary time was lower and MVPA was higher, in the intervention group than in the control group. Fifty percent of the children from the intervention group complied with the MVPA recommendations, vs. 22.7% of those in the control group. Conclusions. The schoolchildren in the intervention group performed more MVPA than those in the control group. Future interventions could include other periods, such as recess and lunchtime, which are opportunities for improving the MVPA levels of schoolchildren.