Schools are universally recognised as key environments to promote physical activity, health, and wellbeing in children and adolescents. School-based interventions focused on physical activity have great potential to have positive impacts on students’ health-related behaviours, health and wellbeing status, practice of teachers, and school policies. However, evidence for the effectiveness of school-based physical activity interventions is mixed due to numerous factors related to (amongst other things) intervention feasibility, implementation fidelity, methodological weaknesses, and outcome selection. The selection and operationalisation of intervention outcomes in particular is critical in determining the effectiveness of school-based physical activity programmes. This presentation will discuss intervention outcomes with reference to effective and ineffective school-based programmes. It will highlight some examples of effective interventions and discuss alignment of intervention characteristics with outcomes. The final part of the presentation will discuss methods of assessing physical activity outcomes in school-based interventions and how these can influence effectiveness.

Project description: Studies of whole school-based physical activity interventions vary in the outcomes they measure. This prevents synthesis of results to establish intervention impacts. We used a modified-Delphi consensus method to develop a core outcome set (COS) agreed by key stakeholders for future studies of whole school-based physical activity interventions. Through a systematic review and steering group workshop, we identified 50 outcomes from which three domains were established: physical activity and health, social and emotional health, and educational performance. We listed these outcomes in a 2-round Delphi survey and recruited 104 key stakeholders (educators, health researchers, parents, public health professionals) of whom 65 completed both survey rounds. We carried out a workshop with children to include their views, and all stakeholders were invited to attend the final consensus meeting to agree the outcomes to be included in the COS. A total of 14 outcomes were agreed to be included in the COS: five outcomes for physical activity and health (diet (varied and balanced), energy, fitness, intensity of physical activity, and sleep (number of hours)); seven outcomes for social and emotional health (anxiety, depression, enjoyment, happiness, self-esteem, stress, and wellbeing); and two outcomes for educational performance (concentration, focus). Impact: We have developed the first COS for whole-school physical activity interventions in consultation with those interested in the development and application of an agreed standardised set of outcomes. Learning: Future studies including these outcomes will reduce heterogeneity across studies from which findings can be compared to establish intervention effects.

School-based physical activity programmes are reported to be largely ineffective in significantly changing children’s physical activity levels when compared to schools following usual practice. A contributing factor may be the methods used to assess, process, analyse, and present physical activity and sedentary time (i.e., movement behaviours) outcomes. Self-report and/or device-based methods are typically used to generate movement behaviour data but there is no consensus on choice of methods, how data are processed, and which outcomes should be reported. This presentation focuses on a longitudinal school-based programme (‘Ready, Set, Move’) delivered in seven primary schools and one secondary school in Pennine Lancashire. The emphasis will be on the rigorous methods used to assess children’s movement behaviours and how the outcomes generated can be used to inform subsequent phases of the programme. Year 4 and Year 7 children wore research grade accelerometers on their non-dominant wrists for 24-hours/day over 8-days between October and December 2023. Accelerations were recorded at a frequency of 100 Hz. Following the data collection protocol, raw acceleration files were obtained. These were processed using open-source software whereby any device calibration errors were corrected, non-wear periods were imputed to maximise available data, summary accelerations were averaged to 1-second epochs, and movement behaviour outcomes were generated then averaged across valid wear days. Importantly, these outcomes were specific to the timing of the start and end of each school’s day, as well as the 24-hour period. The outcomes of interest reflected physical activity volume (average acceleration) and intensity (intensity gradient), absolute and percentage movement behaviour time-use (sedentary time, light, moderate, vigorous physical activity), and the timing and average accelerations for the most and least active 30-minutes of the school day. These outcomes and their application will be described and comparisons made between sub-groups and non-school times.

Introduction

The main goal of the Break4Brain project is to study the effects of active breaks on academic performance, and cognitive and brain function in preadolescent children (10-12 years old) with and without attention deficit hyperactivity disorder (ADHD).

Methods and Results

We will examine the effects of The Break4Brain project through two studies. First, 60 preadolescent children with (n=30) and without (n=30) ADHD will participate in a within-participants crossover pretest-posttest comparison study in the laboratory. These participants will engage in three experimental conditions (control group: inactive condition; intervention groups: physical activity with cognitive engagement and physical activity with high intensity) and will undertake four assessments (one at baseline and three immediately following each experimental condition). Our primary outcome is functional brain function measured with an electroencephalogram. Secondary outcomes will include executive function, academic performance, physical activity and fitness, and motor competence. The second study will aim to recruit a total of 150 school-aged children with a between-participants pretest-posttest comparison design through a cluster randomised controlled trial with allocation occurring at the school level. Schools allocated to the intervention group will deliver one daily active break for ten weeks. The active breaks will be based on videos and will include foundational aerobic and muscle-strengthening activities tailored to meet student needs and interests. The study outcomes will be assessed at baseline and the end of the intervention, including executive function, academic performance and classroom behaviour. We will also conduct economic and process evaluations to determine cost-effectiveness, programme acceptability, implementation and adaptability in schools.

Conclusion

The societal and scientific impact of the Break4Brain study is guaranteed by the ground-breaking and novel nature of the project focusing on educational achievement. By the end of the project, we aim to have produced a significant change in the knowledge of how active breaks can impact key domains (i.e. academic performance, cognition, and brain function) for improving educational achievement in children with and without ADHD.

Purpose: TransformUs program has been shown to improve physical activity (PA) and reduce sedentary time (SED) in primary schools through active pedagogy and supportive classroom and school ground environments. This pilot study aims to trial an adaptation of TransformUs to determine the effect on PA and SED in secondary schools. Methods: This study involved adolescents (n=129) from three Australian schools. Each school selected a different combination of TransformUs strategies (active classrooms, active recreation, and supportive school environments) to increase PA and reduce SED, which included active academic breaks/lessons, standing desks, teacher’s professional development, sport/fitness equipment, and organised activities. Interventions spanned 12, 11, and 6 weeks for schools 1, 2, and 3, respectively. Garmin Vivosmart 4 heart rate monitoring tracked SED and PA (light [LPA], moderate [MPA], and vigorous [VPA]) at baseline, every 2 weeks during the interventions, and at follow-up. Mixed model analysis assessed intervention effects on each school's SED and PA during school, class, and recess times separately. Results: School 1 showed no significant intervention effect. School 2 exhibited increased MPA during class time in the first 2 weeks, with significant variations during recess. School 3 displayed decreased LPA during the second 2 weeks of intervention compared to baseline, particularly during class time. Secondary analysis revealed significant differences within the intervention period, including increased SED and decreased LPA during recess in the first 2 weeks. Conclusion: Overall, no movement behaviours were significantly changed before and after the intervention in any of the three schools during school time. Significant changes in SED, LPA and MPA within the intervention period indicate variability in the response to the implemented strategies.

Introduction: Physical Activity (PA), whilst beneficial for children’s overall wellbeing, has also been proposed to benefit scholastic performance. Schools, vital environments for health promotion strategies, have seen a rise in popularity of PA breaks, the efficacy and effectiveness of which amongst a demanding academic curriculum, is essential. We believe that acute PA may benefit important cognitive and psychological variables which are associated with academic performance. This study aims to investigate the impact an acute PA break, designed by teachers and children, has on such outcomes, whilst also aiming to discern its influence on executive functioning, affect, and arousal individually. Methods: In a within-subjects crossover design, 120 pre-adolescent children performed three conditions in a randomised order: specially designed PA break, usual PA break practice, and a sedentary control. Pre/post/follow-up timepoints measured executive functioning via Stroop and Connections Tests, and arousal and affect by the Felt Arousal Scale and the Feelings Scale respectively. Class teachers evaluated class behaviour in the period between post measures and follow-up (45-minutes post-PA), and children's enjoyment and engagement with the experimental conditions was measured via questionnaires. Anticipated Outcomes and Implications By involving teachers and schoolchildren in the design process, we hope to have developed a PA break that is effective, feasibly implemented, and enjoyable, and verify that schools can prioritise health promotion strategies such as PA breaks without compromising academic demands. Our study examines how an acute PA break impacts factors relevant to academic performance: affect, arousal and executive functioning, aiming to optimise the design using theory and key stakeholder input. Future plans include two distinct strategies: upscaling school inclusion to evaluate the efficacy of the PA break on a much larger scale, while simultaneously directing focused efforts on underrepresented groups and children with disabilities.

Traditional education has long been critiqued for its sedentary nature, leading to prolonged inactivity among students. Acknowledging the pivotal role of physical activity in learning and student well-being, the ALPHYL Project (financing code: PID2020-115075RA-I00) aimed to redefine this landscape by fostering physical literacy (PL) through physically active learning (PAL) experiences in Primary School. This study presents the complementary interventions' opinions and perspectives from educators and researchers involved in the ALPHYL Project. The initiative aimed to infuse PAL approaches across key curricular areas (e.g., Mathematics) and Physical Education (PE), harnessing the body as a tool for enriched learning within an inclusive educational framework. Teachers training and resources co-creation were conducted for six months’ prior the intervention. Over a trimester, a collaborative effort between educators and the ALPHYL team implemented PAL interventions. These included movement-based games, motor skill challenges, and embodied expression, strategically integrated into various subjects across school facilities through effective coordination. In addition, three didactic units were used during PE classes, focusing on the development of the different domains of PL (social, cognitive, physical and psychological). The evaluation involved joint reflection by both educators and researchers after the intervention. Structured meetings facilitated insights into the effectiveness and challenges encountered during the ALPHYL Project. The analysis revealed positive results from both the teachers and the ALPHYL team. These included a reduction in sedentary behavior, increased student engagement, and improvements in the basic psychological needs of autonomy, competence and relatedness, as well as increased student enjoyment. Areas identified for improvement were the material requirements, the complexity of the tasks or the commitment and space required. The positive results obtained support the importance of replicating this type of project in other schools, thus promoting a more active and healthy approach to education. Keywords Physical Literacy; physically active learning; physical activity promotion; primary education.

Background: The positive effects of regular physical activity on adolescents’ physical and mental health are well-established. Despite these benefits, most Swiss adolescents do not meet WHO’s recommended level of physical activity, including a daily minimum of 60 minutes of moderate-to-vigorous physical activity. Due to their widespread accessibility, schools are identified as a key setting to promote physical activity. Recently, the comprehensive school physical activity program (CSPAP), in which physical activity leaders (PALs) play a crucial role to advance school-based physical activity promotion, has been discussed. However, such comprehensive approaches are still lacking in Switzerland, and specific PAL trainings do not exist. Therefore, this study aims to implement and evaluate Active School, a comprehensive school-based physical activity program for Swiss secondary schools with integrated PAL training.

Methods/Design: A cluster randomized controlled trial involving 12 secondary schools (6 experimental, 6 waiting-control schools) will assess baseline data and effectiveness of Active School at 12 and 24 months. Active School includes five CSPAP-based components and each school is encouraged to set individual physical activity goals in this regard. This process is guided by the PALs, who will participate in professional training before and during Active School implementation. As a primary outcome, students’ moderate-to-vigorous physical activity will be assessed via accelerometers. As secondary outcomes, inactivity, light physical activity, step counts and motor performance will be measured, and students’ general wellbeing, learning behavior and psychosocial measures will be assessed by questionnaires. The effectiveness-evaluation is accompanied by a process-evaluation focusing on the implementation outcomes of dose of delivery, reach, feasibility, and sustainability. A mixed methods approach, including ripple effect mapping, will be employed to reconstruct and understand the implementation process.

Discussion: This study will be the first to implement and evaluate a CSPAP in the Swiss school system with specific PAL training and simultaneous application of effectiveness and process-evaluation considered strengths.