School Physical Activity Intervention Research Articles

Fit club: Outcomes from 35-minute daily exercise program for autistic adolescents

BackgroundAutistic children and adolescents have academic performance challenges and are often reluctant to participate in physical activities. Executive function (EF) abilities generally remain stable or worsen as autistic children get older and obesity and lack of physical fitness are frequent concerns experienced by these individuals. Finding ways to address these concerns has the potential to improve outcomes in autistic youth. MethodWe conducted a 12-month, repeated-measures study to examine the effectiveness of a mandatory 35-minute daily school physical activity intervention involving low to moderate exertion for autistic adolescents (n = 29). Changes in fitness, EF, social responsiveness, and restrictive and repetitive behaviors were examined. ResultsSignificant improvements were seen in fitness, EF areas (specifically cognitive flexibility and planning/organizing), restrictive and repetitive behaviors and social responsiveness. ConclusionFindings suggest that participation in a mandatory daily 35-minute physical activity program with low to moderate exertion is feasible and may contribute to improved EF, fitness, restricted and repetitive behavior, and social responsiveness in autistic adolescents.

Development and evaluation of the Capability, Opportunity, and Motivation to deliver Physical Activity in School Scale (COM-PASS)

BackgroundTeachers are recognized as ‘key agents’ for the delivery of physical activity programs and policies in schools. The aim of our study was to develop and evaluate a tool to assess teachers’ capability, opportunity, and motivation to deliver school-based physical activity interventions.MethodsThe development and evaluation of the Capability, Opportunity, and Motivation to deliver Physical Activity in School Scale (COM-PASS) involved three phases. In Phase 1, we invited academic experts to participate in a Delphi study to rate, provide recommendations, and achieve consensus on questionnaire items that were based on the Capability, Opportunity, and Motivation Behavior (COM-B) model. Each item was ranked on the degree to which it matched the content of the COM-B model, using a 5-point scale ranging from ‘1 = Poor match’ to ‘5 = Excellent match’. In Phase 2, we interviewed primary and secondary school teachers using a ‘think-aloud’ approach to assess their understanding of the items. In Phase 3, teachers (n = 196) completed the COM-PASS to assess structural validity using confirmatory factor analysis (CFA).ResultsThirty-eight academic experts from 14 countries completed three rounds of the Delphi study. In the first round, items had an average rating score of 4.04, in the second round 4.51, and in the third (final) round 4.78. The final tool included 14 items, which related to the six constructs of the COM-B model: physical capability, psychological capability, physical opportunity, social opportunity, reflective motivation, and automatic motivation. In Phase 2, ten teachers shared their interpretation of COM-PASS via a 20-min interview, which resulted in minor changes. In Phase 3, CFA of the 3-factor model (i.e., capability, opportunity, and motivation) revealed an adequate fit to the data (χ2 = 122.6, p < .001, CFI = .945, TLI = .924, RMSEA = .066). The internal consistencies of the three subscale scores were acceptable (i.e., capability: α = .75, opportunity: α = .75, motivation: α = .81).ConclusionCOM-PASS is a valid and reliable tool for assessing teachers’ capability, opportunity, and motivation to deliver physical activity interventions in schools. Further studies examining additional psychometric properties of the COM-PASS are warranted.

Co-Creation of a School-Based Motor Competence and Mental Health Intervention: Move Well, Feel Good.

Low motor competence (MC) and inhibited psychosocial development are associated with mental health difficulties. Improving children's MC through school-based physical activity interventions emphasising psychosocial development may therefore be a mechanism for promoting positive mental health. This study describes and provides reflective insights into the co-creation of 'Move Well Feel Good', a primary school physical activity intervention to improve children's MC and mental health. Class teachers, school leaders, physical activity specialists, and children (aged 8-9 years) participated in a series of co-creation workshops. Stakeholders' knowledge and experiences were integrated with existing research evidence using creative methods (e.g., post-it note tasks, worksheets, and drawings) to facilitate discussion. The co-creation process culminated in stakeholder consensus voting for one of three proposed intervention ideas. Children cited physical and mental health benefits, enjoyment with friends, and high perceived competence as motives for being physically active. Opportunities to develop MC across the different segments of the school day were identified by adult stakeholders, who perceived children's lack of resilience, an overloaded curriculum, and poor parental support for physical activity as barriers to intervention implementation. The chosen intervention idea received six out of a possible twelve votes. Co-creation projects are specific to the contexts in which they are implemented. This study reinforces the complex nature of school-based intervention development and highlights the value of engaging with stakeholders in co-creation processes.

Comparing physical activity interventions in schools for youth with visual impairments

Comparing physical activity interventions in schools for youth with visual impairments

S06-4 Exploring correlates of adolescent boys' muscular fitness: a mixed-methods formative study

Abstract Background According to the Elaborated Environmental Stress Hypothesis, anxiety and depression in children are associated with poor motor competence, and these associations may be mediated by social support and self-perceptions. Improving children’s motor competence through school-based physical activity interventions may therefore be a mechanism for promoting positive mental health through psychosocial factors. Co-production provides opportunities to participate in intervention development processes, thereby ensuring that specific needs of stakeholders are targeted. The shared stakeholder ownership of the process provides a context-sensitive basis for acceptable interventions with increased likelihood of them being effectively implemented and resulting in positive outcomes. This presentation describes phase 1 of the Move Well, Feel Good study, which aimed to co-produce and evaluate the feasibility of a primary school physical activity intervention to improve children’s motor competence and mental health. Methods Five primary schools were recruited from a low socioeconomic status community in northwest England. From these schools, stakeholder groups were formed consisting of class teachers, school leaders, physical activity specialists, and children (aged 8-9 years). Stakeholders worked in single and multiple stakeholder groups through a 6-stage process aligned to the Double Diamond Design Approach by employing divergent and convergent thinking processes to discover, define, develop, and deliver a solution to the ‘problems’ of how best to improve children’s motor competence and mental health, and how best to facilitate real-world school context implementation of the intervention. Through this process the child and adult stakeholders worked separately in workshops and engaged in additional learning and consensus activities. The adult stakeholder co-production workshops were informed by the children’s views and current research evidence. Multiple-stakeholder groups worked collaboratively to develop intervention ideas, which were presented, critiqued, and refined in alignment with the TIDieR checklist. Results In the final stage of the process the research team presented the final co-produced interventions back to the stakeholders and a consensus vote was taken to decide which intervention would be implemented in the phase 2 feasibility trial in September 2022. Conclusions School stakeholders’ participation in intervention co-production ensures their ownership of the finalised programme, which may be important for subsequent implementation and engagement.

S06 Engaging peers, parents and pupils to increase physical activity among adolescents

BackgroundRegular physical activity is associated with physiological and mental health benefits for adolescents including improved fitness and cardiometabolic health, increased muscle and bone strength and reduced risk of obesity. Despite this, globally, many adolescents (81%) fail to meet physical activity guidelines. Physical activity levels decline as children move into adolescence and through to adulthood and may affect the likelihood of developing chronic health conditions. It is recognised that parental support and friendship networks play an important role in attenuating declines in physical activity during adolescence and it is vital that we develop effective interventions to help adolescents stay active.AimThis symposium will engage policymakers, professionals, scientists and stakeholders to discuss research projects on Engaging peers, parents and pupils to increase physical activity among adolescents. The goals of this symposium are to highlight the challenges and ongoing work to address sub-optimal levels of physical activity in this population and disseminate the results of novel physical activity interventions to develop knowledge and understanding. This symposium will share experiences, learning and best practice in Patient and Public Involvement (PPI), transitioning from formative research to feasibility testing and upscaling interventions and it will also allow for debate and to identify gaps and priority areas for physical activity among adolescents.Symposia presentations1. Putting young people at the heart of physical activity research design: The Walking In ScHools (WISH) Study (Professor Marie Murphy, Ulster University)This presentation will outline the importance of youth PPI and demonstrate how PPI can be embedded within research design using the WISH Study Youth Advisory Group as a case study.2. The Girls Active Project (GAP): Co-design and feasibility of an after school-based physical activity intervention (Sara McQuinn, Dublin City University)This presentation will discuss the factors influencing physical activity behaviour in adolescents, outline how using public and patient involvement (PPI) and the behaviour change wheel provided a framework for developing the Girls Active Project, and the results from our feasiblity trial.3. Supporting our lifelong engagement: mothers and teens exercising (SOLE MATES); from formative research to feasibility testing (Dr Elaine Murtagh, University of Limerick).Dr Murtagh will discuss the value of formative research in developing interventions and present findings from a novel mother-daughter multi-component physical activity programme.4. Co-production of the Move Well, Feel Good movement behaviours intervention (Stuart Fairclougt, Edge Hill University)This presentation will describe phase 1 of the Move Well, Feel Good study, which aimed to co-produce and evaluate the feasibility of a primary school physical activity intervention to improve children’s motor competence and mental health.5. The Walking In ScHools (WISH) Study: Development and evaluation of a peer-led school-based walking intervention in adolescent girls from pilot to fully-powered trial (Professor Marie Murphy, Ulster University)Professor Murphy will describe how the WISH pilot study guided the development of a full trial to evaluate the effects of a peer-led walking intervention at increasing physical activity in adolescent girls.

Effects of a physical activity intervention on schoolchildren fitness.

The global prevalence of childhood obesity is high. Obesity main causes are linked to sedentary lifestyles. Increasing physical activity (PA) and reducing sedentary activities are recommended to prevent and treat obesity. This study aimed to evaluate the effectiveness of a 6‐month school PA intervention on obesity prevention and healthy behaviors in school‐aged children. Participating students (10–11 years of age) were randomly divided into an intervention group and a control group. Children in the intervention group (n = 80) participated in a multicomponent PA that included improvement in extracurricular physical activities (with an additional 40 min per day for 5/6 days per week). Children (n = 80) in the control group participated in usual practice. Participants had mean body mass index of 19.7 ± 2.9 kg/m2, and 33.7% of them were overweight or with obesity at T0. The change in body mass index in intervention group (−2.4 ± 0.6 kg/m2) was significantly different from that in control group (3.01 ± 1.8 kg/m2). The effects on waist circumference, waist‐to‐height ratio, and physic fitness were also significant in intervention group compared with control group (all p < 0.05). Furthermore, there is a significant decrease in overweight or children with obesity in the experimental group (to 17.5%, p < 0.05). These findings suggest that a school‐based intervention program represents an effective strategy for decreasing the number of overweight and children with obesity.

Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review.

Although best practice recommendations exist regarding school-based healthy eating and physical activity policies, practices, and programs, research indicates that implementation is poor. As the field of implementation science is rapidly evolving, an update of the recent review of strategies to improve the implementation of healthy eating and physical activity interventions in schools published in the Cochrane Library in 2017 was required. The primary aim of this review was to examine the effectiveness of strategies that aim to improve the implementation of school‐based policies, practices, or programs to address child diet, physical activity, or obesity. A systematic review of articles published between August 31, 2016 and April 10, 2019 utilizing Cochrane methodology was conducted. In addition to the 22 studies included in the original review, eight further studies were identified as eligible. The 30 studies sought to improve the implementation of healthy eating (n = 16), physical activity (n = 11), or both healthy eating and physical activity (n = 3). The narrative synthesis indicated that effect sizes of strategies to improve implementation were highly variable across studies. For example, among 10 studies reporting the proportion of schools implementing a targeted policy, practice, or program versus a minimal or usual practice control, the median unadjusted effect size was 16.2%, ranging from –0.2% to 66.6%. Findings provide some evidence to support the effectiveness of strategies in enhancing the nutritional quality of foods served at schools, the implementation of canteen policies, and the time scheduled for physical education.

Young Adolescents’ Perceptions of a Faith-Based Physical Activity Intervention in Parochial Middle Schools

ABSTRACT Background: Faith-based school physical activity (PA) interventions are uncommon. Process evaluations of school PA interventions, in general, rarely include student participant voices. Purpose: We interviewed a subset of participants in Physical Activity for Lent (PAL) – a pedometer-based virtual journey that traces Jesus’s life travels – to understand their various perceptions of the program. Methods: Twenty-two participants (77% ethnic/racial minority) in grades 6–8 representing four Catholic schools participated in focus group interviews. A combination of inductive thematic analysis and deductive analysis was used. Results: Participants claimed to be mindful of being physically active; however, their qualifications of mindfulness primarily cited external cues such as friends. Motivation for and enjoyment of PAL were strongly linked to involvement of friends as competitors and PA co-participants as well as striving to walk like/with Jesus. Expressions of gains in knowledge of and connectedness with Jesus were mostly literal. Discussion: PAL was generally well received although its premise of participants being mindful to perform PA in the spirit of Jesus was subservient to reinforcement from friends. Translation to Health Education Practice: Faith-based interventions in schools should include a strong prosocial component. School staff may need to provide verbal input and modeling of connections between physical activity and faith to deepen young adolescents’ understanding of the religious purpose of such interventions.

Acceptability and Feasibility of Single-Component Primary School Physical Activity Interventions to Inform the AS:Sk Project

Multi-component school-based interventions provide physical activity (PA) opportunities for children but are often difficult for schools to execute and may not be implemented as intended. The primary aim of this study was to explore the acceptability and feasibility of three brief single-component primary school PA interventions targeting 9–10-year-old children. The secondary aim was to examine the effectiveness of the interventions on increasing PA levels and reducing sedentary time. The single-component interventions included active classroom breaks (AB; 3 schools; n = 119 children) Born to Move (BTM) exercise videos (2 schools; n = 50 children), and playground supervisory staff training (2 schools; n = 56 children). Qualitative data from participating children (n = 211), class teachers (n = 6), and playground supervisory staff (n = 8) explored the experiences, acceptability, and feasibility of each intervention component. Accelerometers were worn by 225 children during the last week of implementation. Teachers reported that they were able to implement ABs daily, but BTM videos were more difficult to implement daily because of accessing sufficient space. Playground staff reported difficulties in implementing activities due to children’s age and competing responsibilities on the staffs’ time. Children reported that the ABs and BTM videos were enjoyable. During half hour time windows, including the ABs and BTM videos, children engaged in 4.8 min and 8.6 min of moderate to vigorous PA (MVPA) on average, respectively. ABs and BTM videos positively affected MVPA. ABs were feasible to implement; however, teachers faced some barriers in implementing the BTM videos. Feasibility of playground interventions may be dependent on staff responsibilities and age of the children.

School Physical Activity Intervention Effect on Adolescents' Performance in Mathematics.

The primary aim of this study was to test the effect of a school-based physical activity intervention on adolescents' performance in mathematics. A secondary aim was to explore potential mechanisms that might explain the intervention effect. The Activity and Motivation in Physical EDucation intervention was evaluated using a two-arm cluster randomized controlled trial in 14 secondary schools located in low socioeconomic areas of Western Sydney, Australia. Study participants (n = 1173) were grade 8 students (mean age = 12.94 yr, SD = 0.54). The multicomponent intervention was designed to help teachers maximize students' opportunities for moderate-to-vigorous physical activity (MVPA) during physical education (PE) and enhance students' motivation toward PE. Mathematics performance was assessed as part of national testing in grade 7, which was the year before the trial began and then again in grade 9. Potential mediators were: (i) proportion of PE lesson time that students spent in MVPA and leisure time MVPA (%), measured using Actigraph GT3X+ accelerometers, and (ii) students' self-reported engagement (behavioral, emotional, and cognitive) during mathematics lessons. Mediators were assessed at baseline (grade 8) and follow-up (grade 9, 14-15 months after baseline). The effect of the intervention on mathematics performance was small-to-medium (β = 0.16, P < 0.001). An intervention effect was observed for MVPA% in PE (β = 0.59, P < 0.001), but not for leisure time MVPA or any of the engagement mediators. There were no significant associations between changes in potential mediators and mathematics performance. The Activity and Motivation in Physical EDucation intervention had a significant positive effect on mathematics performance in adolescents. However, findings should be interpreted with caution as the effect was small and not associated with changes in hypothesized mediators.

Improved Executive Function and Science Achievement for At-Risk Middle School Girls in an Aerobic Fitness Program

This study explored the effects of a middle school physical activity intervention for adolescent girls on the executive functioning involved in science learning. The girls, ages 11 to 14, were at risk for low self-esteem, sedentary lifestyle, and poor health outcomes. Executive function stems from interdependent cognitive control processes that influence goal setting and information processing, which complement higher order thinking required for acquiring scientific process skills. A 20-week informal triathlon training program served as the intervention for the treatment girls ( n = 29). The comparison group of girls ( n = 30) was randomly drawn from a matched sample of students of a similar demographic. Mean comparisons, ANCOVA, and Roy-Bargmann stepdown analysis were used to measure outcomes. The intervention contributed to significant improvement in several executive functions and science achievement. These results suggest that an afterschool program with a physical fitness component may improve the executive functions involved in science learning.

Pupils’ experiences of autonomy, competence and relatedness in ‘Move for Well-being in Schools’: A physical activity intervention

Physical activity at school can be beneficial to children’s psychosocial well-being. To realise this potential, a school environment that supports physical activity is crucial. Self-Determination Theory provides the basis for one approach, namely to focus on pupils’ need to feel competent, autonomous and related. The purpose of this study was to investigate how pupils experienced a school physical activity intervention based on Self-Determination Theory and to assess whether the components developed for the intervention appeared to increase the pupils’ sense of competence, autonomy and relatedness, thereby furthering their psychosocial well-being. Two schools were selected to take part in a qualitative case study, with one grade four (ages 9–10) and one grade six (ages 12–13) class selected for closer monitoring. Ten semi-structured focus group interviews were carried out, involving 36 pupils, combined with 28 days of participant observations. The data were analysed based on the principles of deductive content analysis, using competence, autonomy and relatedness in the categorisation matrix. Findings showed that the pupils’ sense of relatedness was central to well-being and influenced their sense of competence and autonomy. Changing the physical activity climate to focus on mastery and learning instead of competing and performance was challenging, but in some instances brought about more positive experiences, especially for pupils with limited motivation in school physical activity. Finally, while being given influence and choice evidently promoted the sense of autonomy, some pupils felt uncomfortable choosing activities on behalf of the group.

An internet-supported school physical activity intervention in low socioeconomic status communities: results from the Activity and Motivation in Physical Education (AMPED) cluster randomised controlled trial

ObjectiveQuality physical education (PE) is the cornerstone of comprehensive school physical activity (PA) promotion programmes. We tested the efficacy of a teacher professional learning intervention, delivered partially via the internet,...

Physiotherapists enabling school children's physical activity using social cognitive theory, empowerment and technology

Aim: To contribute knowledge concerning how physiotherapists using social cognitive theory, empowerment and information and communication technology can promote children’s physical activity in a school context.Methodology: Four studies were conducted in the northern part of Sweden and a qualitative discourse analysis of the results from all four studies was performed to enable a more comprehensive understanding. Three of the studies involved children, and one study involved parents.Major findings: The findings formed three themes: A, Acknowledging empowerment; B, Bonded forces overcame barriers; and C, Competence and motivation enable change. The first theme includes the act of creating the intervention using an empowerment approach. The second theme concerns barriers to being physically active and social support from parents and peers regarding physical activity promotion. The third theme concerns motivation and associated personal factors, such as self-efficacy.Principal conclusion: This course of action might be a way for physiotherapists to promote children’s physical activity using social cognitive theory, empowerment and information and communication technology in a school context. An empowerment approach that includes the formation of partnerships with children is a promising avenue for developing physical activity interventions in schools. In addition, physical activity interventions should attempt to build on children’s self-efficacy and make physical activity opportunities fun and enjoyable.

Governing indigenous recreation at a distance: a critical analysis of an after school active health intervention

ABSTRACTWithin the Canadian context, the physical activity levels of children and youth in the after school time period has become a source of public health concern. We argue that this concern is informed by broader public health crises, in particular the ‘global obesity epidemic’ and the closely related ‘global pandemic of physical inactivity', and that these so-called ‘crises’ operate as part of a discursive regime that serves to justify after school interventions aimed at increasing the physical activity practices of children and youth. Although the objectives of such interventions are seemingly well intentioned, we suggest that such interventions nonetheless harbor difficult to discern, but potentially pernicious consequences, for the communities in which they are implemented. We focus our attention on the place-specific effects of one Public Health Agency of Canada-funded after school physical activity intervention – After the School Bell Rings (ASBR) – that was implemented in the mostly Indigenous, northern community of Placid, Manitoba. Based on a critical analysis of the ASBR program itself, along with interviews and focus groups with children, parents and recreation providers (n = 10) from the community of Placid, we contend that the ASBR serves to govern Indigenous recreation at a distance. We argue that when implemented in the place-specific context of Placid, the ASBR functions as part of a broader governmental assemblage composed of loosely connected discourses, institutions, socio-structural conditions and individuals that, when assembled, ultimately serve to govern geographically and culturally distinct communities. We conclude by suggesting that the objectives of broad-based health interventions, such as the goal of increasing after school physical activity levels, should not be universally implemented across diverse locales, but need to account for the diverse, place-specific priorities and needs of the communities into which they are implemented.

The role of travel mode in engagement with a Radio Frequency ID chip based school physical activity intervention

The role of travel mode in engagement with a Radio Frequency ID chip based school physical activity intervention

Physical activity interventions in schools for improving lifestyle in European countries.

Background : In the last decades, children’s and adolescents’ obesity and overweight have increased in European Countries. Unhealthy eating habits and sedentary lifestyle have been recognized to determine such an epidemic. Schools represent an ideal setting to modify harmful behaviors, and physical activity could be regarded as a potential way to avoid the metabolic risks related to obesity. Methods : A systematic review of the literature was carried out to summarize the evidence of school-based interventions aimed to promote, enhance and implement physical activity in European schools. Only randomized controlled trials were included, carried out in Europe from January 2000 to April 2014, universally delivered and targeting pupils aged between 3 and 18 years old. Results : Forty-seven studies were retrieved based either on multicomponent interventions or solely physical activity programs. Most aimed to prevent obesity and cardiovascular risks among youths. While few studies showed a decrease in BMI, positive results were achieved on other outcomes, such as metabolic parameters and physical fitness. Conclusion : Physical activity in schools should be regarded as a simple, non-expensive and enjoyable way to reach all the children and adolescents with adequate doses of moderate to vigorous physical activity.

Can schoolyard improvements increase physical activity for the least active students, or just provide better opportunities for the most active?

Introduction School physical activity interventions can improve the physical environment and organizational environment of schools to increase the opportunities for physical activity (PA) in recess. The purpose of this study was to evaluate if improvements to the outdoor physical environment at the school had equal impact on all students regardless of their PA at baseline [1] . Method The SPACE-study used a cluster randomized controlled study design with a 2-year follow-up, and enrolled 1348 students aged 11–13 years from 14 schools in Denmark. A web-based questionnaire was used to obtain knowledge of PA during recess and in leisure time. The multicomponent intervention comprised 11 components, and included a combination of changes to the physical environment and organizational changes. Results At baseline, 73% of the students reported to engage in sport outside school and were characterized as “the most active”. At the intervention schools the proportion of student who reported good possibilities for outdoor PA increased (71% to 75%), while the proportion decreased at the comparison schools (87% to 68%). The proportion of students reporting to be active daily during recess decreased for all groups (87% to 58%). The decrease was smaller at the intervention schools (88% to 62%), but only for the students characterized as the most active at baseline (90% to 66%). Furthermore, there was large variation between intervention schools. Conclusion The intervention produced considerable changes to the environment of all seven intervention schools, and had a positive impact on self-rated PA during recess for the most active students at baseline.

Effects of After School Physical Activity Intervention to Reduce Obesity Among Indian Adolescent Boys

Background: Obesity is increasing rapidly in developing countries undergoing rapid nutritional transition. This transition has affected the lifestyle with a reduction in the energy expenditure along with an increase in energy intake. Therefore, obesity has no longer remained a Western problem alone. However, in India little attention is paid towards adolescent obesity until recently. Subjects &amp; methods: Boys (n=229) covering the age 9-15 years were included. Measurements at baseline and follow-up included weight, height, body fat %, skin fold thickness at four sites, waist circumference and blood pressure. After school intervention consisted of five 60 minutes sessions per week. After one academic year the effect of physical activity intervention on adiposity was evaluated. Results: Subjects with high participation in daily physical program of the school showed significant reduction in body fat (1.0 %), skin fold thickness at triceps (1.3mm) and biceps (1.2mm) as compared to their baseline measurement. Further the prevalence of overweight among high participation group showed significant decrease compared to low participation group. More importantly there was a significant reduction in all three indicators of central adiposity highlighting the beneficial effect of physical activity as an intervention in tackling the overall as well as central adiposity among adolescents. Our observation thus highlights the fact that though it may be difficult to administer dietary intervention in growing children there is a potential in administrating physical activity program for at least 50 minutes/ day for school children for combating adolescent obesity. Conclusion: Findings from the current study brings out for the first time highlights potential benefits of physical activity and the concern for introducing it into the curriculum on a daily basis rather than weekly basis which is currently prevalent in all the schools for better health of adolescents.