A106: School-Based Physical Activity Interventions on Cardiorespiratory Fitness and Body Composition in Children and Adolescents: A-Meta-Analysis-Using-the-RE-AIM-Framework

Abstract

This systematic review and meta-analysis aimed to (1) assess the effects of school-based physical activity (PA) interventions on cardiorespiratory fitness (CRF) and body composition in children and adolescents, and (2) evaluate the reporting of internal validity (i.e. Reach and Effectiveness) and external validity (i.e. Adoption, Implementation, and Maintenance) within included studies using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. A comprehensive search was conducted across five databases (PubMed, Embase, Web of Science, EBSCO, and Cochrane Library) for studies published from January 1, 2000, to July 10, 2024. Eligible studies included randomized and non-randomized controlled trials involving healthy children and adolescents aged 5 to 17 years. Only studies that reported CRF or body composition with PA or exercise as the sole intervention were included. The RE-AIM framework was applied to assess study quality. 43 studies with a total of 27,626 participants were included in the meta-analysis. School-based PA interventions had a significant positive effect on CRF (SMD = 0.28, 95% CI = 0.19 to 0.38, P \u3c 0.001; I² = 75%). Subgroup analysis revealed a significant positive effect on CRF in studies involving mixed-gender groups (SMD = 0.30, 95% CI = 0.20 to 0.40; I² = 76%), while no significant effects were found in studies involving only boys or girls. Furthermore, no significant effect of school-based PA interventions on percentage of body fat (%BF) was observed (SMD = -0.05, 95% CI = -0.10 to 0.00, P = 0.054; I² = 28%). The total proportion of the RE-AIM framework reported was 48.1%. Among the five dimensions, Effectiveness is the most frequently reported (72.7%), followed by Reach (53.1%), Adoption (52.3%), Implementation (42.4%), and Maintenance (4.7%). School-based PA interventions significantly improve CRF in children and adolescents, particularly among mixed-gender populations, though the effect on reducing %BF is not significant. Moreover, reporting of internal validity was more frequent than external validity in the included studies of the RE-AIM framework