School-based Physical Activity Research Articles

Are school settings restricting access to daily physical activity for children with cystic fibrosis? Parents’ perspectives and recommendations for practice

ABSTRACT Background Cystic Fibrosis (CF) is a genetic life limiting disease that impacts upon quality of life. An aim of CF care is to preserve lung function, with physical activity (PA) being an important part of daily airway clearance. Ensuring children have opportunities to engage in PA at school should be an important part of their daily routine. It is important to gain parental perspectives on this, as they manage the daily care for their children. This study aims to explore parents’ perceptions of school-based PA for their children with CF. Methods Parents of children with CF (n = 10), from three regions of the UK (England, Wales and Northern Ireland) took part in online semi-structured interviews. Data were analysed using Interpretative Phenomenological Analysis (IPA). Results Although parents recognized the benefits of school-based PA for their children, systemic barriers in the school setting often inhibit daily PA for children with CF, including teachers’ misconceptions, emotional and physical barriers, and PA not being a priority. Conclusion Recommendations for practice have been developed to help engage children with CF in daily school-based PA in an inclusive way, with the hope of maintaining health outcomes for children with CF.

Challenges and barriers in conducting school-based physical activity research: A narrative review

ABSTRACT Physical activity (PA) is associated with numerous mental and physical health benefits. But it has been observed that young people and children frequently participate in low levels of PA, which is especially noticeable when they progress from primary to secondary school. Thus, in order to improve physical health among school-going children, different schools should put in place school-based PA intervention programs. The researchers designing PA intervention protocols for school children encounter various challenges during implementation; hence, this narrative review determines the challenges and barriers faced by the researchers during data collection on PA of school-going adolescent children. The review highlighted the challenges encountered during implementation of school-based PA and fitness among school children. The key issues mentioned in the review involved problems related to communication with schools, recruitment of participants along with the informed consent, implementation and data collection, environment of school, and barriers to PA in school. The documentation of these difficulties can help advance knowledge of the researchers and their efficacy, which will finally result in the development of strengthened and close relationships with school-based educational institutions, leading to implementation of intervention protocols and enhancing physical fitness in school children.

Black Girls as Transformative Leaders in Physical Activity Programs

Background: Black adolescent girls possess a unique ability to inspire and enact change in their communities, yet are overlooked in discussions of leadership and empowerment. Coupled with deficit approaches to school-based physical activity programming, positioning Black girls as physical activity leaders is missing from practice. BLinG-HealthTM (Black Leadership in Girls’ Health) trained peer leaders in group fitness instruction instrumental in delivering group fitness sessions in an 8-week after-school physical activity pilot program. Methods and Analysis: This paper presents the qualitative data illustrating the program's impact on Black girls leading peers in a group fitness setting using general inductive narrative analysis based on group interviews, observations, reflection notes, and faculty leadership testimonials. Results: Participants exuded community, collaboration, and confidence. Peer leadership was effective but differed. Girls recognized the program's benefits and challenges while enjoying it. Conclusion: Black girls can lead physical activity initiatives when allowed to do so while building a community. Researchers and school and community activists should empower Black girls to lead physical activity programs to foster better health outcomes.

The Effects of the LiiNK Intervention on Physical Activity and Obesity Rates among Children

Background: Obesity and inactivity among children are at an all-time high and have been steadily increasing in prevalence over the last thirty years. The school environment provides the ideal setting for reaching a large number of children across diverse populations in order to reverse these trends. However, there are many inconsistent results yielded by school-based physical activity interventions due to implementation length, time for activities, and the use of structured physical activities. The LiiNK Project® is a whole-child intervention addressing these gaps by providing children 45–60 min of recess (unstructured, outdoor play) in their schools daily, while the control children are allowed to engage in recess for 30 min daily. The purpose of this study was to compare the physical activity intensity and obesity rates of third- and fourth-grade children participating in the LiiNK intervention, which provides 60 min of recess for third graders and 45 min for fourth graders, to those in a control group allowed 30 min of daily recess. Methods: The children were 8–10 years old (M = 9.2; 52% females and 48% males). The intervention children comprised 90 third graders and 100 fourth graders, and the control children comprised 101 third graders and 92 fourth graders. Physical activity levels were monitored using accelerometers to assess sedentary, light, and moderate-to-vigorous physical activity (MVPA). Obesity rates were evaluated using bio-electrical impedance analysis (BIA), in which body fat percentage is calculated based on normative values using age and sex in the equation. Results: The third-grade intervention children engaged in 13 more MVPA minutes and took 900 more steps daily than their control counterparts, and also presented a greater proportion of overweight children transitioning to a healthy weight status from the fall to the spring semester. Conversely, the fourth-grade control children increased their activity by 500 steps and 15 more MVPA minutes daily. Despite this, the intervention children overall demonstrated a reduction in body fat percentage, while the control children demonstrated an increase in body fat percentage. Conclusions: Ultimately, 60 min of unstructured, outdoor play in schools provides children the best opportunity to engage in MVPA, which may positively impact body fat percentages, offering a potential strategy for combatting childhood obesity in school settings.

Comprehensive School Physical Activity Programming in Dubai International Schools: A Mixed Methods Study

The purpose of this study was to examine comprehensive school physical activity program (CSPAP) policies and practices in interna-tional schools in Dubai, the United Arab Emirates. Following an ex-planatory-sequential mixed-methods research design, the researchers employed the Comprehensive School Physical Activity Program Policies and Practices Questionnaire (CSPAP-Q) and follow-up interviews to describe CSPAP implementation and explore implementation enablers and challenges. A convenience sample of physical education teachers (N=18) participated in the questionnaire, and seven of these teachers participated in individual interviews. Teachers’ responses to the ques-tionnaire indicated considerable heterogeneity and numerous gaps in existing school-based physical activity opportunities and promotion O'Reilly and Websterefforts. Interviews revealed three themes related to CSPAP implemen-tation: (a) time constraints in secondary schools, (b) facilities, and (c) location. This study provides an initial glimpse into whole-of-school physical activity programming in Dubai international schools.

Sit Less, Move More!? A Pilot Study on the Effectiveness of a National School-Based Physical Activity Program

Sit Less, Move More!? A Pilot Study on the Effectiveness of a National School-Based Physical Activity Program

Effectiveness of school-based physical activity programs in enhancing attention, academic performance, and social relationships among children with intellectual disabilities: evidence from Pakistani schools.

Physical activity (PA) offers extensive benefits for all children, including those with intellectual disabilities (ID), who face significant challenges in behavioral management and psycho-social well-being. This study investigates the effects of school-based PA on attention, academic performance, and relationships with teachers and parents in children with ID. A 12-week single-blind randomized controlled trial was conducted with 102 children with ID, aged 6 to 12 years (71 boys and 31 girls) from grades 1 to 5. Participants were divided into three groups: MVPA (moderate to vigorous PA), MPA (mild PA), and NPA (no PA). Each group engaged in PA three times a week for 45 min per session, with activities planned by a fitness trainer and supervised by the researcher. Outcome measures were assessed using SNAP-IV, STRS, CPRS, and APRS scales before and after the intervention. The results indicated that MVPA had a more significant positive impact on all outcomes compared to MPA and NPA. MPA also produced notable improvements relative to NPA. These findings underscore the importance of integrating PA into educational settings as a comprehensive strategy to enhance attention, academic performance, and social interactions for children with ID. This research highlights PA as a vital tool for addressing behavioral challenges and fostering better developmental outcomes in this population.

Increasing adolescents’ physical activity levels through a comprehensive school-based physical activity program: study protocol of the cluster randomized controlled trial Active School

BackgroundThe positive effects of regular physical activity on children and adolescents’ physical and mental health are well-established. Despite these health benefits, most Swiss adolescents do not meet WHO’s recommended level of physical activity, which includes a daily minimum of 60 min of moderate-to-vigorous physical activity. Due to their inclusivity, schools are identified as a key setting to promote physical activity. Recently, the comprehensive school physical activity program (CSPAP), in which teachers as physical activity leaders (PALs) play a crucial role to advance comprehensive 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, the aim of this study is to implement and evaluate Active School, a comprehensive school-based physical activity program for Swiss secondary schools with integrated PAL training.Methods/designA cluster randomized controlled trial (RCT) 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 components based on the CSPAP. 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 development 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, aerobic fitness and coordination will be measured, and students’ general wellbeing, learning behavior, and multiple psychosocial measures related to physical activity will be assessed by questionnaires. The effectiveness evaluation is accompanied by a process evaluation that focuses 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.DiscussionThis study will be the first to implement and evaluate a CSPAP in the Swiss school system. The specific PAL training and the simultaneous application of effectiveness and process evaluation are considered strengths of the study.Trial registrationGerman Clinical Trials Register (DRKS00033362). Date of registration: January 25, 2024. Retrospectively registered.

255 Evaluation and Comparison of Government-Funded School-Based Youth Physical Activity Counseling Initiatives in Finland for the 2024-2025 Academic Year

255 Evaluation and Comparison of Government-Funded School-Based Youth Physical Activity Counseling Initiatives in Finland for the 2024-2025 Academic Year

104 Impact of a School-Based Physical Activity Intervention program on Physical Activity Levels, Sleep Patterns, Aerobic Fitness, and Motor Competence

104 Impact of a School-Based Physical Activity Intervention program on Physical Activity Levels, Sleep Patterns, Aerobic Fitness, and Motor Competence

Promoting an Active School Culture: Tools, Resources, and Recognition

Within a whole-of-school approach to student wellness, comprehensive school physical activity programs (CSPAPs) offer opportunities for physical activity before, during, and after the school day. However, to successfully influence behavior and fully reap the physical, cognitive, and psychological benefits of an active lifestyle, schools must strive to embed a culture of physical activity into the fabric of the school community. The national Active Schools movement, established to provide schools with the necessary tools to ensure that all children in the United States have the opportunity to participate in 60 minutes of physical activity each day, has developed a framework for an active school culture that includes nine essential elements. This article introduces the framework and describes the open-source tools and resources offered through Active Schools to promote school-based physical activity, including foundational guidance documents, assessment tools, professional development opportunities, and a school recognition system.

Optimizing intervention dissemination at scale: A qualitative study of multi-sector partner organization experiences.

For population-wide impact of interventions, evidence-based programs must be successfully disseminated and adopted at scale. Research-practice partnerships can legitimize programs and support organizational adoption, however, ways of leveraging the contributions of partners during dissemination processes are less clear. TransformUs is a school-based physical activity and sedentary behaviour program, and since 2018, has been disseminated at scale to all primary schools in Victoria, Australia, in partnership with 16 state and national organizations. The study objective was to investigate the experiences of partner organizations disseminating TransformUs within their networks, and factors associated with awareness and adoption of the program in schools, from the perspective of partner organizations. Semi-structured interviews with representatives from 15 (out of 16) partner organizations in 2019 involved in disseminating TransformUs state-wide. An interview guide was informed by the RE-AIM framework. Interviews were audio-recorded, transcribed, and coded anonymously. Data were analysed thematically. Four themes (and 13 sub-themes) were identified: (i) organizational barriers and facilitators to dissemination; (ii) implementation support for partners; (iii) overall research experience; and (iv) dissemination strategy. Partners used multiple dissemination channels to increase adoption, and strong alignment between TransformUs and the partner organization's goals appeared to enable dissemination. Partners outlined several local, regional, and state organizations to partner with, and offered suggestions regarding preferred content and timing of dissemination activities for their networks. Researchers planning research-practice partnerships should proactively consider organizational barriers partners may face during dissemination. Regular communication and feedback on dissemination outcomes may contribute to positive research-practice experiences and allow for tailored dissemination strategies.

The Effectiveness of Physical Activity Intervention at School on BMI and Body Composition in Overweight Children: A Pilot Study

(1) Background: Overweight children usually have lower levels of physical activity (PA) than their normal-weight peers. Low PA predisposes to an increase in body fat mass. The aim of this study was to evaluate the effectiveness of school-based PA intervention on the anthropometric indicators and body composition of overweight and obese children during a two-year observation period, from the age of 10 to 12. (2) Materials and methods: The research included 148 children with overweight or obesity who were born in 2007. There were two groups of children with standard and elevated PA at school (SPA and EPA; 4 and 10 h of physical education lessons a week, respectively). Anthropometric and body composition measurements were carried out. Body mass index (BMI), fat mass (FM), fat-free mass (FFM), skeletal muscle mass (SMM), and total body water (TBW) were estimated. In total, five measurements were conducted at intervals of 5–6 months. (3) Results: In EPA group, the percentage of obese children decreased from 46% to 35.25%, and in SPA group, this percentage increased from 42.75% to 46%. Only 3.33% of children in the standard PA group (one child) and 17.2% in the elevated PA group (six children) changed their BMI and FM categories from overweight to normal body mass. In EPA children, FM decreased from 28.65% to 26.41%, and in SPA children, it increased from 30.31% to 31.75%. The highest increase in FFM was in EPA boys, while SPA boys recorded the highest decrease. In SPA children, SMM increased by 0.43% from 38.85% to 39.28%, and in EPA children, it increased by 2.51% from 40.27% to 42.78%. In EPA children, TBW slightly increased from 53.26% to 53.59%, and in SPA children, it decreased from 50.70% to 49.93%. (4) Conclusions: Elevated PA at school has a positive effect on the BMI and body composition of children who are overweight or obese. Increasing the mandatory number of physical education lessons in school curricula is an efficient strategy for reducing obesity in school-aged children.

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.

Methodology for evaluation of complex school-based health promotion interventions.

There is a need for careful examination of large volumes of collected (structured and unstructured) information related to school-based evaluation. There is also no published, comprehensive framework/s for evaluating complex interventions in Irish primary schools. The aim of this paper is to outline a methodology for process evaluation of an Irish primary school-based physical activity (PA) and nutrition intervention. Evaluation followed the three themes outlined by the British Medical Research Council: implementation, context, and mechanism of impact that we further divided into six dimensions. Methodological tools included questionnaires, PA logs, reflective journals, write and draw, and semi-structured interviews. We triangulated findings across these multiple tools to assess each dimension. We designed a unique framework to enable comparisons and offer researchers a template for evaluating complex health promotion interventions in primary schools. We present a methodology for evaluating a complex school-based health promotion intervention. The framework we propose integrates process and outcome data. It aims to enhance future result interpretation and facilitate informed comparisons among intervention schools.

School-level intra-cluster correlation coefficients and autocorrelations for children’s accelerometer-measured physical activity in England by age and gender

BackgroundRandomised, cluster-based study designs in schools are commonly used to evaluate children’s physical activity interventions. Sample size estimation relies on accurate estimation of the intra-cluster correlation coefficient (ICC), but published estimates, especially using accelerometry-measured physical activity, are few and vary depending on physical activity outcome and participant age. Less commonly-used cluster-based designs, such as stepped wedge designs, also need to account for correlations over time, e.g. cluster autocorrelation (CAC) and individual autocorrelation (IAC), but no estimates are currently available. This paper estimates the school-level ICC, CAC and IAC for England children’s accelerometer-measured physical activity outcomes by age group and gender, to inform the design of future school-based cluster trials.MethodsData were pooled from seven large English datasets of accelerometer-measured physical activity data between 2002–18 (> 13,500 pupils, 540 primary and secondary schools). Linear mixed effect models estimated ICCs for weekday and whole week for minutes spent in moderate-to-vigorous physical activity (MVPA) and being sedentary for different age groups, stratified by gender. The CAC (1,252 schools) and IAC (34,923 pupils) were estimated by length of follow-up from pooled longitudinal data.ResultsSchool-level ICCs for weekday MVPA were higher in primary schools (from 0.07 (95% CI: 0.05, 0.10) to 0.08 (95% CI: 0.06, 0.11)) compared to secondary (from 0.04 (95% CI: 0.03, 0.07) to (95% CI: 0.04, 0.10)). Girls’ ICCs were similar for primary and secondary schools, but boys’ were lower in secondary. For all ages, combined the CAC was 0.60 (95% CI: 0.44–0.72), and the IAC was 0.46 (95% CI: 0.42–0.49), irrespective of follow-up time. Estimates were higher for MVPA vs sedentary time, and for weekdays vs the whole week.ConclusionsAdequately powered studies are important to evidence effective physical activity strategies. Our estimates of the ICC, CAC and IAC may be used to plan future school-based physical activity evaluations and were fairly consistent across a range of ages and settings, suggesting that results may be applied to other high income countries with similar school physical activity provision. It is important to use estimates appropriate to the study design, and that match the intended study population as closely as possible.

Whole-of-School Physical Activity Promotion: Findings From Elementary Schools in the United States

IntroductionSchools can support students’ participation in physical activity by offering opportunities consistent with a Whole-of-School (WOS) approach; however, the extent to which physical activity opportunities are provided and how school-level characteristics associate with their use remains unclear. This study examined how elementary schools’ use a WOS approach to promote physical activity, as well as associations between school-level characteristics and physical activity opportunities provided. MethodsSurvey data was collected from 162 elementary schools participating in the NFL PLAY 60 FitnessGram Project during the 2022–23 school year. A WOS index (ranging from 0–12) was created from responses by school staff on questions about six physical activity practices (physical education, recess, before- and after-school programs, classroom-based approaches, active transport). Multivariable regression models examined associations between school characteristics and WOS index scores. Analyses were completed in Spring 2024. ResultsFully adjusted models indicated a statistically significant difference between the percentage of economically disadvantaged students served and WOS index score. Schools serving between 20–39% (p<0.001), 40–59% (p<0.01), 60–79% (p<0.01) and ≥80% (p<0.001) economically disadvantaged students scored significantly lower on the WOS index compared to schools with 0–19% economically disadvantaged students. ConclusionStudies are needed to examine disparities in physical activity practices consistent with a WOS approach to understand the implications on health, academic performance, and other key outcomes. This information can inform the development of strategies to address disparities and ensure youth have equitable access to school-based physical activity opportunities.

Effect of a pragmatic lifestyle modification intervention on physical activity levels and body mass index among obese and overweight adolescents in Udupi, India: a cluster randomized trial.

Determine the effects of a multifactorial lifestyle intervention on physical activity (PA), BMI and health-related quality of life (QoL) in obese and overweight adolescents. Nine schools in India were clustered randomly in a 12-month study with students allocated to a multifactorial intervention (MFI), or exercise only (EX) or control (CON) group. Participants were adolescents aged 11-16 years (n=671). In the MFI group, adolescents and their parents received lifestyle education using a validated booklet combined with a PA intervention for school students. The EX group received school-based PA only; the CON group continued regular activities. Primary outcomes were PA levels measured with the PAQ-A, and BMI; the secondary outcome was health-related QoL. A linear regression statistical model was used to analyse time, group effects and interactions, with Bonferroni correction for within-group differences at baseline (T0) and at 12-weeks (T1) (post-intervention), 6-month (T2) and 12-month (T3) follow-ups. Significant time and group effects observed for all groups with PA scores (p<0.001), with MFI group having largest increase in PA; with BMI (p<0.001) and MFI showing the least gain in BMI; and HRQOL (p<0.001), with MFI group showing greatest improvement in scores. There were significant increases in PA at T1 and T3 time-points with the EX group, and at T3 time-point only for MFI and CON, with MFI group showing largest increase in HRQOL scores. BMI increased significantly for all groups at T2 (MFI p=0.001, EX p<0.001) and T3 (p<0.001), while HRQOL increased significantly for both MFI and EX at both follow-ups (p<0.001). School-based lifestyle MFI was more effective for improving PA, lifestyle behaviours and HRQOL than exercise alone for adolescents, although BMI was not reduced. MFI with PA could be an effective school-based approach for behaviour modification but BMI has limitations for measuring body composition changes. CTRI/2019/04/018834 (30/04/2019).

Learning Health System to rapidly improve the implementation of a school physical activity policy

BackgroundLearning Health Systems (LHS) – characterised by cycles of evidence generation and application – are increasingly recognised for their potential to improve public health interventions and optimise health impacts; however there is little evidence of their application in the context of public health practice. Here, we describe how an Australian public health unit applied a LHS approach to successfully improve a model of support for implementation of a school-based physical activity policy.MethodsThis body of work was undertaken in the context of a strong research-practice partnership. Core LHS capabilities included: i) partnerships and stakeholder engagement; ii) workforce development and learning health communities; iii) multi-disciplinary scientific expertise; iv) practice data collection and management system; v) evidence surveillance and synthesis; and vi) governance and organisational processes of decision making. Three cycles of data generation and application were used. Within each cycle, randomised controlled trials conducted in NSW primary schools were used to generate data on the support model’s effectiveness for improving schools’ implementation of a government physical activity policy, its delivery costs, and process measures such as adoption and acceptability. Each type of data were analysed independently, synthesised, and then presented to a multi-disciplinary team of researchers and practitioners, in consult with stakeholders, leading to collaborative decisions for incremental improvements to the support model.ResultsCycle 1 tested the first version of the support model (composed of five implementation strategies targeting identified barriers of policy implementation) and showed the model’s feasibility and efficacy for improving schools’ policy implementation. Data-informed changes were made to enhance impact, including the addition of three implementation strategies to address outstanding barriers. Cycle 2 (now, testing a package of eight implementation strategies) established the model’s effectiveness and cost-effectiveness for improving school's policy implementation. Data-informed changes were made to reduce delivery costs, specifically adapting the costliest strategies to reduce in-person contact from external support personnel. Cycle 3 showed that the adaptations minimised the relative cost of delivery without adversely impacting on the effect.ConclusionsThrough this process, we identified an effective, cost-effective, acceptable and scalable policy implementation support model for service delivery. This provides important information to inform or support LHS approaches for other agencies seeking to optimise the health impact of evidence-based interventions.

A 10-week implementation of the FIT FIRST FOR ALL school-based physical activity concept effectively improves cardiorespiratory fitness and body composition in 7-16-year-old schoolchildren.

The purpose of the present study was to investigate the impact of the FIT FIRST FOR ALL school-based physical activity program on health-related physical fitness in Faroese schoolchildren. The program aimed to add three weekly sessions of organized high-intensity physical activity to the standard weekly physical education sessions for all pupils across the entire school. A non-randomized controlled design was used to evaluate the effects of the program. Two schools participated, including one intervention school (INT; n =179) and one control school (CON; n =181), with pupils aged 7-16 years (grades 1-9). The FIT FIRST FOR ALL program consisted of three weekly 40-minute sessions of age-adjusted high-intensity physical activity over 10 weeks for the INT school, while the CON school continued their normal school program. Pre- and post-intervention assessments included cardiorespiratory fitness (Yo-Yo IR1C test), agility (Arrowhead Agility test), postural balance (Stork Stand), standing long jump performance, body composition, blood pressure, and resting heart rate. A significant time × group effect (p < 0.001) was observed for cardiorespiratory fitness, which increased by 31% [23;39] in INT (p < 0.001) and remained unaltered in CON (7% [-2;16], p = 0.13). In addition, a time × group effect (p < 0.001) was observed for agility, which improved by 2.1% [1.0;3.2] in INT (p < 0.001) and regressed by 3.3% [2.3;4.4] in CON (p < 0.001). No significant between-group effects were found for standing long jump and balance. A time × group effect (p < 0.001) was observed for changes in total muscle mass, which increased by 1.4 kg [1.2;1.5] in INT (p < 0.001) and by 0.4 kg [0.3;0.6] in CON (p < 0.05). Furthermore, a time × group effect (p < 0.001) was observed for total fat percentage, which decreased by -2.3% [-2.8;-1.9] in INT (p < 0.001) and remained unchanged in CON (-0.3% [-0.7;0.1], p = 0.16). No significant time × group effects were found for blood pressure and resting heart rate. The FIT FIRST FOR ALL program significantly improved cardiorespiratory fitness and agility, and it led to favorable changes in body composition in the intervention school. These findings suggest that the program is highly effective in enhancing physical fitness and health status across all investigated age groups when implemented at a school-wide level.