Promoting well-being in schools: an evaluation of active breaks training for teachers

PurposeA more dynamic school day that includes less sitting and more physical activity throughout the day may support health in primary school children. In this mixed methodologies study, we assessed which physical activity possibilities are incorporated in the school policies of Dutch primary schools and if this translates into more physical activity in pupils.MethodsSeven primary schools were included in the study. The head teachers completed a questionnaire on the incorporation of physical activity in the school policy. Physical activity policy was assessed for physical education, physical activity during breaks, scheduling of physical activity during lessons, after school physical activity and active transport to school. In each school, actual physical activity was objectively measured using accelerometers in pupils in two classes and planning and logging of PA by teachers.ResultsWe will assess the impact of the school policy on physical activity in pupils using logistic regression. We will assess the impact of the several school policies on total physical activity in pupils, and on the three (light, moderate and high) modalities of physical activity.ConclusionThe results of this study will give us more insight in the current role of physical activity in Dutch primary schools. The potential impact of the school policy on physical activity levels in pupils can be used as a starting point for a more integral dynamic school day approach.Support/Funding SourceThis study was partially funded by “Stichting Westelijke Tuinsteden’.

Approximately 77% of NSW children aged 5 to 15 years do not meet physical activity guidelines and many spend a considerable amount of time sitting. Active breaks at primary school are feasible, may increase daily moderate to vigorous physical activity (MVPA) and decrease off-task behaviour without adversely affecting cognitive function and learning. In this quasi-experimental study, 101 primary school children in six intervention classrooms participated in three 10-minute active breaks per day for six-weeks during class time, while five control classrooms were run as usual (n=89). Physical activity levels were measured using wrist-worn Actigraph wGT3X-BT accelerometers and analysed using a random forest model. Students' off-task behaviour, wellbeing, cognitive function and maths performance were also measured. School staff completed a brief feedback survey. Children in the intervention group engaged in 15.4 and 10.9minutes more MVPA per day at 3 and 6 weeks respectively (P < .001). Participation significantly increased the proportion of children who met the Australian 24-Hour Movement Guidelines (P < .001). At pre, middle and end of intervention, 44.4%, 60.8% and 55.1% of intervention children and 46.5%, 45.9% and 45.8% of controls met the guidelines. Significantly fewer students engaged in off-task behaviour in the intervention classes at mid andfinal weeks of intervention (-1.4 students, P=.003). No significant intervention effects were found for wellbeing, cognitive and maths performance. Active classroom breaks are an effective way to increase physical activity among primary school children while reducing off-task classroom behaviour. SO WHAT?: Primary school students' health would benefit from active breaks with no detrimental effects on wellbeing, maths and cognitive performance.

BackgroundThere is little evidence on the tracking of physical activity during school hours. In addition, tracking physical activity in schools provides important evidence for understanding children’s physical activity and conducting intervention studies. Therefore, this study examined longitudinal changes and tracking of in-school physical activity in primary school children.MethodsIn this study, physical activity was investigated longitudinally in primary school children for 4 years. The baseline participants consisted of 103 second-grade students (7–8 years old) who participated. Step counts and moderate-to-vigorous physical activity (MVPA) in school and during first recess and lunch/second recess were examined using an accelerometer (Kenz Lifecorder GS 4-second version; Suzuken Co. Ltd, Nagoya, Japan).ResultsAfter excluding missing data (moving school; n = 8, physical activity; n = 8), 87 (43 boys and 44 girls) of whom were included in the final analysis. Step counts and MVPA during school and physical education in boys did not decrease across the school years. By contrast, in girls, step counts during school did not decrease across the school years, however MVPA did decrease. In addition, for both sexes, step counts and MVPA during first recess decrease across the school years. During lunch/second recess, only step counts decrease across the school years in both sexes. In addition, the tracking coefficients for step counts and MVPA for boys in school and during first recess and lunch/second recess were found across many school years. Contrarily, girls had fewer significant tracking coefficients between school years than boys. There were also few significant tracking coefficients between grades for physical education step counts and MVPA for both boys and girls.ConclusionsOur results suggested that in-school step counts for both boys and girls does not decrease across the school years. However, given that girls demonstrated reduced levels of in-school MVPA across the school years, it is important to promote strategies to increase MVPA in this group.

Aim: In this paper, we examine how ambidextrous organisational practices can be used to advance the management of public basic schools in accepting behaviours that can improve physical activities of children.&#x0D; Methodology: Drawing on extant literature and desk review of policy documents including school reports, we examine physical activities in public basic schools in Ghana and then explore three key developmental systems – managerial responsiveness, healthcare variation and educational development and highlight four areas from these systems; organisational processes, infrastructure development, human resource improvements, and stakeholder collaboration where policy makers can focus their efforts to improving physical activity in school children in Ghana.&#x0D; Findings: The findings demonstrate a seeming absence of structures for physical activity in public basic schools in Ghana - presenting severe consequences, especially for the healthy growth of children, proper integration of children into society, learning processes, and developing talents for future sporting activities in general. Again, the analysis shows that the Ghana Education Service’s implementation guidelines for physical activity in public basic schools are not yielding the needed results - thus provoking policy dialogues in managerial practices for effective implementation of those guidelines. Next, we propose the promotion of physical activity in public basic schools in Ghana through sustainable and pragmatic approaches drawing from ambidextrous managerial practices to strengthen organisational capacity in the schools for improvements in movement behaviours, lifestyle changes, active learning, and physical activity levels of school children.&#x0D; Conclusion: Practical approaches are needed to enhance the physical activity for children and this requires the initiation of active schools’ programme in public basic schools – and clearly learning from best practices in the last decades, examples from other countries provide a really useful approach in the years ahead.

Physical activity in the form of "active breaks" can be combined with academic instruction in primary school. However, few studies have examined the feasibility of conducting active breaks in secondary school. To address this gap, we conducted focus groups (FGs) regarding the implementation of an active breaks (ABs) protocol with 20 teachers and 10 secondary school students. Barriers/facilitators toward the implementation of ABs were classified using grounded theory inductive methods framed by the socio-ecological model. Individual-level factors were instrumental for both teachers and students. Teachers highlighted personal fears and concerns regarding using ABs, while students reported fears related to peer behaviour during the activity. Both teachers and students agreed that ABs can improve cognitive skills and time-on-task behaviour. Teachers articulated concerns related to student behaviour during ABs including possible social exclusion and injury. Students felt that ABs might affect classroom management and interfere with maintaining students' academic focus. Teachers underscored that ABs required social support from the administration and colleagues. Students felt that ABs could support teachers' instructional focus and provide them with an energy respite. Collectively, the FGs suggested that environmental limitations could hinder the implementation of ABs. Involving teacher and student feedback during the codesign phase can rationally inform the design of school-based ABs.

The current study aims to determine the extent to which current issues and anticipated problems in the Anthropocene are addressed in the learning outcomes of the curricula prepared by the Ministry of National Education (MoNE) for primary, middle, and high school levels (Anatolian High Schools). In addition, the study aims to describe the current state of the learning outcomes in these curricula in terms of guiding learners towards practical applications, developing original solutions, and actively participating in solving the problems humanity faces today and will face in the future in line with the concept of the Anthropocene and problem-centred curriculum designs. To do so, the study employed the content analysis method and analyzed the curricula of required courses at primary, middle and high school (Anatolian High Schools) levels that were in use in 2018. In the analysis of the data, categories based on various problem areas were developed, and the distribution and frequency of the curriculum outcomes across these categories were determined. Moreover, in order to explore the presence of problem areas in the learning outcomes, the latter were analyzed according to the criteria determined in line with problem-centred curriculum designs. It was found that the problem areas are addressed in the learning outcomes of middle school curricula to the greatest extent, followed by the learning outcomes in primary and high school (Anatolian High School) curricula. As the education levels progress, a consistent increase in the number of outcomes that fully address the problem areas is not observed. Among the outcomes at all levels of primary, middle and high school education (Anatolian High Schools), the most frequently addressed problem areas are Traditions and culture at risk and Artificial intelligence and new technologies. The problem areas that are least frequently addressed in the outcomes at all three levels are Lack of decent work and opportunities and Migration. The results suggest that various problem areas in the Anthropocene that affect the nature and humanity today and tomorrow should be included in a balanced manner across all education levels and in the curricula of required courses suitable to all age groups. It is also recommended that curricula be designed in such a way as to train individuals who can foresee future problems, produce solutions to them and subsequently implement these solutions.

This thesis is part of the School in Motion study. School in Motion was initiated by the Norwegian government because of the political demand for more knowledge regarding possible approaches to increase adolescent physical activity. The reason for the demand was a report depicting 15-year-olds as among the most sedentary populations in Norway. This is concerning because physical activity can have a preventive function against non-communicable diseases, psychological difficulties and mental disorders. Norwegian schools are given extended responsibilities for their students’ physical and mental health. Physical activity can contribute in this purpose, therefore, finding feasible approaches to increase physical activity in school is an important research topic. The School in Motion study was a cluster randomized controlled trial involving 29 lower secondary schools in Norway. The participants were 2084 9th graders (14-15 years old) from schools located in western, south western, southern, and eastern parts of the country. The study aimed to implement two separate intervention models for increased physical activity and physical education in school, in order to evaluate their effects on physical activity, physical health, mental health, learning and learning environment. Intervention model 1 included weekly, 30 minutes of physical activity, 30 minutes of physically active academic lessons, and one additional physical education lesson. Intervention model 2 included two weekly physical activity lessons in which students were encouraged to pursue their own activity interests, in groups they formed themselves. The aims of this thesis were to elucidate different aspects of the relationship between school-based physical activity interventions, physical fitness and mental health among adolescents, and the feasibility of school-based PA interventions in lower secondary school. The data that are presented in this thesis are the basis of four separate papers. The first paper analyzed baseline data to examine the cross-sectional association between physical fitness and mental health. The results showed a small, inverse association between cardiorespiratory fitness and mental health, while no association was found between mental health and body composition or muscular strength. The second paper presents data from a qualitative study that aimed to elucidate how intervention model 2 was implemented, and what influenced the implementation. The results showed large differences in how the intervention was implemented. Specifically, two out of four investigated schools implemented the intervention adequately, one school implemented the intervention partially adequate and the last school failed at several implementation aspects. Four main factors were responsible for influencing implementation: frame factors, intervention-, participant-, and provider characteristics. The results elucidate the challenge of implementing a complex physical activity intervention in schools, i. e., complex contexts, and expecting the implementation process to be similar for the schools. The third paper examined the effect the interventions had on mental health, by using a cluster randomized controlled trial design. The results showed no intervention effects on the overall population. However, subgroup analyses indicated that intervention model 1 was beneficial for those with high levels of psychological difficulties at baseline, and both intervention models were beneficial for the immigrant subgroup. The results also indicated that intervention model 2 had a negative effect on a subscale of psychological difficulties, peer relationships, within the subgroups non-immigrant girls, and those with “borderline” psychological difficulties at baseline. The fourth paper presents associations between the one-year change in physical fitness components and mental health status. Subgroup analyses showed an inverse association between change in cardiorespiratory fitness and mental health status among boys; an inverse association between change in muscular strength and mental health status among immigrants; and an association between change in cardiorespiratory fitness and mental health among girls with high socioeconomic status. The results indicate that the associations between physical activity, physical fitness and mental health among adolescents depend on different mechanisms that are specific to certain subgroups. The findings of this thesis add nuance to a research field characterized by relatively few studies, small sample sizes, cross-sectional designs and little qualitative knowledge. In summary, this thesis suggests that improving cardiorespiratory fitness can be beneficial for mental health promotion among adolescent boys; and that improving muscular strength can be beneficial for mental health promotion among adolescent immigrants. Moreover, school-based PA programs can be useful for mental health promotion among adolescents with high levels of psychological difficulties and among adolescent immigrants. Regarding the implementation of physical activity programs in schools, this is feasible. However, a successful implementation depends to a large degree on schools’ facilities and frame factors, thus, the physical activity programs should have flexible designs to secure an optimal fit in each individual school. The new Core curriculum in Norway for primary and secondary education specifies that physical and mental health is to be an important interdisciplinary topic in school. The knowledge generated through this thesis can contribute to the development of this interdisciplinary topic, and to the ongoing discussion about the role of physical activity and mental health in school.

BackgroundThe school has been identified as a key arena for physical activity promotion for young people. Effective change of physical activity behaviour requires identification of consistent and modifiable correlates. The study explores students' interests in school physical activity and facilities in the school environment and examines their associations with students' participation in physical activity during recess and their cross-level interaction effect.MethodsThis cross-sectional study was based on a national representative sample of Norwegian secondary schools and grade 8 students who participated in the Health Behaviour in School-aged Children (HBSC) 2005/06 study. The final sample comprised 68 schools and 1347 students. Physical environment characteristics were assessed through questionnaires completed by the principals, and students' physical activity and interests in physical activity were assessed through student self-completion questionnaires.ResultsMost students were interested in more opportunities for physical activity in school. Multilevel logistic regression models demonstrated that students attending schools with many facilities had 4.49 times (95% Confidence Interval (CI) = 1.93–10.44) higher odds of being physically active compared to students in schools with fewer facilities when adjusting for socio-economic status, sex and interests in school physical activity. Also open fields (Odds Ratio (OR) = 4.31, 95% CI = 1.65–11.28), outdoor obstacle course (OR = 1.78, 95% CI = 1.32–2.40), playground equipment (OR = 1.73, 95% CI = 1.24–2.42) and room with cardio and weightlifting equipment (OR = 1.58, 95%CI = 1.18–2.10) were associated with increased participation in physical activity. Both students' overall interests and the physical facilitation of the school environment significantly contributed to the prediction of recess physical activity. The interaction term demonstrated that students' interests might moderate the effect of facilities on recess physical activity.ConclusionThe findings support the use of an ecological approach and multilevel analyses in the investigation of correlates of physical activity that allows for a broader understanding of the influence of and interaction between factors at multiple levels on physical activity behaviour. In the promotion of physical activity in lower secondary schools, the study suggests that programmes should include a focus on environmental facilitation and incorporate strategies to increase students' interests for school physical activity.

Objectives. Non-communicable diseases and limited participation in school physical education have become increasing concerns in South Africa. In response to these concerns, a schoolbased physical activity intervention, Healthnutz, was implemented in three primary schools in Alexandra Township, Johannesburg. Evaluation of Healthnutz included assessing its feasibility and acceptability, and short-term changes in learners’ physical fitness, knowledge and attitudes. Methods. To assess feasibility and acceptability, a situational analysis and focus groups with teachers and programme monitors were conducted. Pre-post fitness testing (3-month interval) was conducted with learners, and a questionnaire assessed changes in learners’ knowledge, attitudes, self-efficacy, and perceived barriers to physical activity, in control and intervention schools. Results. At implementation, teachers identified the need for more physical activity in the school environment and were positive about Healthnutz. Follow-up focus group discussions suggested that it was positively impacting teachers, learners and the school in general. Scores for sit and reach (p&lt;0.001), sit ups (p&lt;0.02) and shuttle run (p&lt;0.0001) improved significantly in intervention but not control schools. A significant decrease was observed in learners’ perceived external barriers to physical activity (p&lt;0.0001) along with a positive change in learners’ self-efficacy for physical activity (p&lt;0.05). Conclusions. Healthnutz raised awareness of the importance of physical activity in intervention schools. Findings indicate that even limited exposure to a physical activity intervention can lead to a significant improvement in aspects of learners’ fitness, knowledge, attitudes and perceptions regarding physical activity. Furthermore, training and support of teachers needs to be nonjudgemental and empowering.

Background According to the WHO recommendations, children and adolescents should perform at least 60 minutes per day of moderate to vigorous physical activity (PA). Active Breaks (ABs) interventions, short physical activity breaks of 5-15 minutes during school hours, have been examined in primary school children as a potential strategy to counteract a sedentary lifestyle, with minimal disruption to school learning activities. The aim of the BRAVE STUDY is to investigate the feasibility of ABs in a secondary school setting from the students’ point of view. Methods In December 2020, 10 students (age 12-13, 6 females and 4 males) attending the second and third grade of secondary schools located in Bologna province (Italy) were involved in a focus group (FG). The FG was conducted online because of COVID-19 and the answers transcribed for a later analysis. Students’ opinions were probed on the role of PA in school and possible facilitators/barriers to implementation of ABs in the school. Results Students reported they wanted to be more active as a consequence of time spent in class sitting at a desk. Students also reported that an organized activity like ABs conducted in the classroom setting provides an excellent opportunity to improve social relations with classmates. Students also highlighted the possible psycho-physical well-being benefits arising from PA. Among the potentially negative aspects reported, students underlined the possible confusion that would be created in classroom and the time subtracted from academic learning activities. Conclusions The FG represents an ideal mean to obtain in-depth information on how people feel about a pending program or a change in their routine. The current FG reinforces positive outcomes from exposure to a PA program that can be intertwined with their daily classroom activities. ABs programs can help to reconcile the needs of students that arise during the day with the PA objectives recommended by the WHO. Key messages • ABs can be a zero-cost intervention strategy to achieve WHO recommendations and would create conditions for a greater psycho-physical benefits in classrooms. • A qualitative approach, such as FGs, provides a mean to collect information not obtainable with quantitative methods, that could be useful to co-design interventions for children and adolescents.

Background Physical inactivity is worldwide considered one of the biggest public health problems of the 21st century. WHO recommended in children, at least 60 minute of Moderate Vigorous Physical activity (MVPA) per day, but low percentages comply with guidelines. Considering that children spend many hours at school, classroom is the ideal setting to increase their PA. Active Breaks (AB) are a 5-15-minute bouts of PA led by the teachers during academic lessons. The aim of the Imola AB study is to implement a 1-year intervention based on AB (10min/3per-day) in primary school as a new strategy to reduce inactivity. We present the baseline results. Methods Quasi-experimental pre-post study in 6-10aged primary school children, in Imola(Italy).We evaluated PA level with Actigraph accelerometers: time (in minutes) spent in MVPA Weekly and Daily (W-MVPA; D-MVPA) and Weekly Sedentary behaviours (W-SB). Results We recruited 152 children: N = 110 in Active Breaks experimental group (AB) and N = 42 in control group (CG). Actigraph's analysis showed that 42,5% of children in the ABG vs 31.0% in the CG reach the WHO recommendation (p=ns). We investigated baseline differences between groups using ANOVA dividing children by grade. In 3-4 grades: W-MVPA (AB = 318.3±15.5 vs CG = 310.4±98.0 p = 0.78); D-MVPA (AB = 53.0±20.3 vs CG = 51.8±16.3 p = 0.79);W-SB (AB = 6,687.5±375.3 vs CG = 6,754.7±281.0 p = 0.45). In 1grade: W-MVPA (AB = 376.1±127.9 vs CG = 300.3±120.0 p = 0.02); D-MVPA (AB = 62.7±21.3 vs CG = 50.0±20.0 p = 0.02); W-SB (AB = 6,436.0±496.0 vs CG = 6,373.3 ±1,532.0 p = 0.7). Conclusions Only the 39.2% of the total sample met the 60-minute/day of MVPA recommended. We found no significant baseline differences in PA level measured by Actigraph between CG and AB, excepted in 1 grade. The intervention implemented in the Imola AB study could be a good strategy to reduce sedentary in children and reach the WHO recommendation, thus contributing to the aims of the new Global Action Plan on PA 2018-2030. Key messages Less than 50% reach the WHO recommendations of PA. AB implemented in the Imola Study could be a public health school-based strategy to reduce sedentary and increase healthy behavior in children. Active breaks (AB) are emerging as a good strategy to increase the PA level, reducing the time in sedentary habits.

Provincial inequality indexes in school enrollments are computed for the years 1980 and 1994 using primary, middle and high school enrollment rates for the provinces of Turkey. Summary measures of both interprovince and intraprovince inequality are computed for the two years; the former measure is an indicator of inequality across provinces, and the latter measure is an indicator of inequality in access to education within provinces. The purpose is to provide a nearly fifteen-year perspective on provincial inequalities at each level of schooling and also of inequalities across the three levels of schooling in each province. Several main points are noted. First, as expected, inequality in enrollments across provinces was lowest at the primary school level since primary schooling is compulsory. Second, except at the high school level, inequality in enrollments declined between 1980 and 1994. Third, the results indicate higher female enrollment inequalities than those found for total enrollments at all levels of schooling. Fourth, the results for models explaining interprovince changes in enrollment rates indicate convergence at the primary and middle school levels. Fifth, per capita income and degree of rurality of each province are important determinants of intraprovince inequality.

This review analyses educational intervention studies that have researched the effects of physical activity in school on schoolchildren’s cognition. Twenty-nine intervention studies carried out between January 2005 and the end of June 2019 were retrieved from five databases. Fourteen papers analysed the physically activity in academic lessons (PAAL) method, nine analysed the effects of active lesson breaks (ALB), two analysed active recess (AR) intervention, and three analysed combined physical activity (CPA) interventions consisting of two or more types of physical activity. Physical activity in school time has acute and chronic positive effects on cognition in children. In all the interventions (PAAL, ALB, AR, and CPA) short-term high-intensity physical activity sessions improved cognitive performance. Medium- to long-term moderate vigorous physical activity sessions also produced improvements in cognitive performance. The implications of including CPA programmes in the school timetable are discussed and practical guidelines with recommendations are offered.

Effective physical activity (PA) interventions are warranted for youth, and schools have been identified as logical locations for such involvement. Experts and professionals in the field promote comprehensive school PA programs, including classroom PA. The purpose of this study was to determine the effect of a low-cost, teacher-directed classroom-based intervention on the school PA of elementary children. Nine classroom teachers were provided inexpensive curricula and trained to implement and instruct PA breaks (2 × 30 minute training sessions). The teachers were encouraged to lead 1 activity break per day after the training. One hundred and six elementary students wore pedometers up to 12 days over 3 monitoring periods during the school year (baseline, follow-up, post follow-up) to assess the effectiveness and the sustainability of the intervention. The teachers self-reported the frequency of activity breaks instructed. The teachers (n = 5) who complied with the recommended 1 activity break per day had students who accrued ∼33% more mean school steps/day at follow-up (∼1100) and post follow-up (∼1350) compared to controls. Teachers (n = 4) in the intervention who did not comply with the 1 activity break per day recommendation had students accrue similar mean school steps/day as controls. Inexpensive, teacher-directed classroom-based PA interventions can be effective in improving children's PA levels if teachers implement 1 activity break per school day. We recommend promoting the notion of 1 activity break per day in the classroom as part of a comprehensive school PA program that includes quality physical education, recess, and before/after school programs.

Despite recognition that regular physical activity is essential for good health, many children do not accumulate sufficient daily physical activity. The aim of this study was to examine the effect of a classroom-based activity break on accelerometer-determined moderate-to-vigorous intensity physical activity (MVPA) and adiposity in primary school children. One hundred twenty children from seven primary schools in Northern Ireland participated in the study. In each school, one class of children was randomly assigned to an intervention group and another class to a control group. Teachers of the intervention classes led a 5-min activity break three times per day for 12 weeks. Accelerometer-determined MVPA, height, weight and four skinfolds were measured at baseline and post-intervention. Compared with the control group, the intervention group significantly increased weekday MVPA (+9.5 min) from baseline to post-intervention. There were no significant changes in BMI; however, an increase in sum-of-skinfolds of the intervention group was observed. Classroom-based activity breaks led by the teacher are successful in increasing children's physical activity levels. The programme shows a positive step in improving overall physical activity levels and contributing to the goal of 60 min daily MVPA.