title: Systematic Review and Meta-Analysis of Multi-Component Interventions Through Schools to Increase Physical Activity.
abstract: BACKGROUND
  A "whole-of-school" approach is nationally endorsed to increase youth physical activity (PA). Aligned with this approach, comprehensive school physical activity programs (CSPAP) are recommended. Distinct components of a CSPAP include physical education (PE), PA during the school day (PADS), PA before/after school (PABAS), staff wellness (SW), and family/community engagement (FCE). The effectiveness of interventions incorporating multiple CSPAP components is unclear. A systematic review and meta-analysis were conducted examining the effectiveness of multicomponent interventions on youth total daily PA.
  
  
  METHODS
  Electronic databases were searched for published studies that (1) occurred in the US; (2) targeted K-12 (5-18 years old); (3) were interventions; (4) reflected ≥ 2 CSPAP components, with at least 1 targeting school-based PA during school hours; and (5) reported outcomes as daily PA improvements. Standardized mean effects (Hedge's g) from pooled random effects inverse-variance models were estimated.
  
  
  RESULTS
  Across 14 studies, 12 included PE, 5 PADS, 1 PABAS, 2 SW, and 14 FCE. No studies included all 5 CSPAP components. Overall, intervention impact was small (0.11, 95% CI 0.03-0.19).
  
  
  CONCLUSIONS
  As designed, there is limited evidence of the effectiveness of multicomponent interventions to increase youth total daily PA. Increased alignment with CSPAP recommendations may improve intervention effectiveness.
authors.affiliation: Dept of Kinesiology and Health Science, Georgia Regents University, Augusta, GA.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Russ
authors.forename: Collin A
authors.initials: CA
authors.lastname: Webster
authors.forename: Michael W
authors.initials: MW
authors.lastname: Beets
authors.forename: David S
authors.initials: DS
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D015444:Exercise; D006801:Humans; D010806:Physical Education and Training / Q000379:methods*; D012574:Schools