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School-based physical activity interventions increase adolescent activity short-term but not long-termCan school programs get teens moving? Yes, but only for a few months

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Key Takeaway
Consider school-based activity interventions for short-term adolescent gains, but plan for long-term sustainability.

This systematic review and meta-analysis examined the efficacy of school-based physical activity interventions compared to control conditions in adolescents aged 10-19 years. The analysis included approximately 17,000 adolescents from 90 studies conducted in school settings. Interventions included multicomponent programs, activity lessons, educational awareness sessions, and after-school activities.

The primary outcome was improvement in physical activity levels. In the short term (0-6 months), interventions significantly increased physical activity with a standardized mean difference of 0.41 (95% CI 0.23-0.59). However, no significant long-term effects were observed beyond six months of follow-up for overall activity, sedentary behavior, or body mass index. Secondary outcomes including fitness, sedentary behaviors, and BMI were also assessed.

Safety and tolerability data were not reported in the analysis. Key limitations include high heterogeneity across the included studies, which complicates interpretation of the pooled results. The certainty of evidence was rated as low to moderate, with low certainty specifically noted for the short-term effect.

For clinical practice, these findings suggest school-based interventions can produce short-term increases in adolescent physical activity, but sustaining behavioral change may require long-term, system-level strategies involving schools, families, and communities. The evidence should be interpreted cautiously due to methodological limitations and heterogeneity.

We all know teens should move more, but getting them to actually do it is tough. Schools often try to help with special programs, from activity lessons to after-school clubs. Now, a major review of 90 studies involving about 17,000 adolescents gives us a clearer picture of what works—and what doesn't last.

The analysis found that these school-based efforts do make a real difference in the short term. For the first six months, teens in the programs were significantly more active than their peers who didn't participate. The catch? That positive effect disappeared when researchers looked at results beyond six months. The programs didn't lead to lasting changes in overall activity, time spent sitting, or body mass index (BMI) in the long run.

It's important to interpret these findings with some caution. The researchers rated the certainty of the evidence as low to moderate, partly because the included studies were quite different from each other. What this tells us is that a school program alone isn't a magic bullet. Getting a teenager to adopt a more active lifestyle and stick with it is complex. The authors suggest that lasting change might need a coordinated, long-term strategy that involves not just schools, but also families and the wider community.

What this means for you:
School activity programs help teens in the short term, but effects fade after six months.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up228.0 mo
PublishedMar 2026
View Original Abstract ↓
BACKGROUND: Physical inactivity among adolescents is a significant challenge contributing to rising cases of obesity, noncommunicable diseases (NCD), and mental health challenges. A viable strategy is the promotion of physical activity (PA) in the school setting. We conducted a systematic review and meta-analysis to assess the efficacy of school-based physical activity interventions, compared to control conditions, in improving activity outcomes in adolescents. METHODS: We followed PRISMA guidelines and searched Scopus, Embase, CINAHL, PubMed, and Cochrane from 2000 onwards for relevant studies in English. We included randomised controlled trials (RCTs) involving adolescents aged 10-19 years with interventions in school-based settings and outcomes including activity, fitness, sedentary behaviours, and body mass index (BMI). We conducted a meta-analysis of included studies, assessed them using the Risk of Bias (ROB) 2 tool from the Cochrane handbook, and evaluated evidence quality through the GRADE framework. RESULTS: The search yielded 30 629 records, of which 90 studies including approximately 17 000 adolescents met the inclusion criteria. Interventions included multicomponent programmes, activity lessons, educational awareness sessions, and after-school activities. In the short term (0-6 months), school-based interventions significantly increased physical activity levels (standardised mean difference (SMD) = 0.41, 95% confidence interval (CI) = 0.23-0.59; low-certainty evidence). However, these improvements were not sustained beyond six months of follow-up, with pooled analyses showing no significant long-term effects on overall activity, sedentary behaviour, or BMI. CONCLUSIONS: School-based interventions can modestly increase adolescents' physical activity in the short term, but their effects diminish over time. Sustaining behavioural change may require long-term, system-level strategies that involve schools, families, and communities. Overall, the certainty of evidence was low to moderate, and findings should be interpreted with caution due to high heterogeneity across studies.
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