Public policies to increase physical activity and reduce sedentary behavior: a narrative synthesis of “reviews of reviews”

Figures & data

Figure 1. Flowchart of the literature search.

Table 1. Reviews of reviews included in study.

Authors	Title of publication	Date of publication	Study objective	Number of reviews included	Quality of reviews assessed?
Kriemler, Meyer, Martin et al. [15]	“Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update”	2011	“[T]o summarise recent reviews that aimed to increase PA or fitness in youth and carry out a systematic review of new intervention studies.”	20	Yes. 10-item checklist. Study receives 1 point for each positive item.
van Sluijs, Kriemler, and McMinn [16]	“The effect of community and family interventions on young people’s physical activity levels: a review of reviews and updated systematic review”	2011	A review of reviews and updated systematic review to assess the effect of community and family interventions on the PA levels of young people.	3	Yes. 10-item checklist. Study receives 1 point for each positive item.
Biddle, Petrolini, and Pearson [17]	“Interventions designed to reduce sedentary behaviours in young people: a review of reviews”	2014	“To synthesise systematic reviews and meta-analyses of interventions aimed at decreasing sedentary behaviours among children and adolescents.”	10	No
Brand, Pischke, Steenbock et al. [18]	“What works in community-based interventions promoting physical activity and healthy eating? A review of reviews”	2014	“[T]o assess the effectiveness of community-based interventions to promote physical activity and healthy eating.”	18	Yes. A Measurement Tool to Assess Systematic Reviews (AMSTAR).
Zubala, MacGillivray, Frost et al. [19]	“Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews”	2017	“To [evaluate] the effects and characteristics of PA promotion interventions aimed at community dwelling people over 50 years old.”	19	Yes. ROBIS.
Belogianni and Baldwin [20]	“Types of Interventions Targeting Dietary, Physical Activity, and Weight-Related Outcomes among University Students: A Systematic Review of Systematic Reviews”	2019	To “identify systematic reviews and meta-analyses of studies aiming to improve health outcomes in university students, to assess their methodological quality, to identify the different types of interventions used and outcomes assessed, and to estimate their overall effect.”	8, of which 2 included PA outcomes	Yes. AMSTAR 2.
dos Santos, Filho, da Silva, et al. [21]	“What works in sedentary behavior interventions for youth: a review of reviews”	2019	To synthesize evidence to “determine which interventions strategies/characteristics are powerful in reducing sedentary behavior among children and adolescents.”	29	Yes. AMSTAR.
Messing, Rütten, Abu-Omar et al. [22]	“How Can Physical Activity Be Promoted Among Children and Adolescents? A Systematic Review of Reviews Across Settings”	2019	To conduct a systematic review of reviews in order to develop national recommendations for PA promotion in Germany.	39	Yes. AGREE.
Gelius, Mesing, Goodwin et al. [13]	“What are effective policies for promoting physical activity? A systematic review of reviews”	2020	To summarize currently available evidence on effective policies for promoting PA	57	No.
Mannocci, D’Egidio, Backhaus et al. [23]	“Are there effective interventions to increase physical activity in children and young people? An umbrella review”	2020	To summarize the existing evidence regarding interventions that aim to increase PA among children and youths.	30	Yes. AMSTAR 2.
Nguyen, Le, Nguyen et al. [24]	“The effectiveness of sedentary behaviour interventions on sitting time and screen time in children and adults: an umbrella review of systematic reviews”	2020	To conduct an umbrella review that synthesizes systematic reviews examining the effectiveness of sedentary behavior interventions on sitting time and screen time.	17	Yes. AMSTAR.
den Braver, Bengoeschea, and Messing et al. [25]	“The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens”	2022	To “summarize the evidence from published reviews on the effectiveness of mass-media campaigns to promote physical activity (PA) or PA-related determinants” [and] “to identify policy-relevant recommendations related to successful PA campaigns.”	22	Yes. AMSTAR 2.

Table 2. Potentially effective PA-promoting public policies for which quantitative estimates are available.

Public policy	Description	Reported effect size	Source
Physical education
• Mandatory PE	a policymandating daily physical education for all schoolchildren	23 minutes of MVPA gained per day	Bassett, Fitzhugh, Heath et al. (2013) [44]
• Standardised PE curricula	Standardized curricula (e.g. Sports, Play, and Active Recreation for Kids [SPARK]) that increase the proportion of MVPA time during physical Education.	6 minutes of MVPA gained per day	Bassett, Fitzhugh, Heath et al. (2013) [44]
Breaks during school
• Recess	Recess periods of 15 minutes for elementary and middle school children.	7 minutes of MVPA gained per day	Bassett, Fitzhugh, Heath et al. (2013) [44]
• Classroom activity breaks	Breaks – usually 10 minutes in duration – that add a physically active component to the academic material being taught. These programs typically are offered in elementary schools (see, e.g. Physical Activity Across the Curriculum, TAKE 10! and Energizers).	19 minutes of MVPA gained per day	Bassett, Fitzhugh, Heath et al. (2013) [44]
School programming
• After-school activity programs	Provision of a supervised PA program for children for several hours between the end of the school day and the time parents pick up their children.	22.6% increase in weekly MVPA (from a baseline of 1,902.7 metabolic equivalents)	Kristensen, Flottemesch, Maciosek et al. (2014) [67]
		10 minutes of MVPA gained per day	Bassett, Fitzhugh, Heath et al. (2013) [44]
Other
• Walking groups	e.g., lay-mentored meetings, led walking training, and educational sessions	30–60 minutes per week	Ogilvie, Foster, Rothnie et al. (2007) [50]

We define “potentially effective” policies as specific public policies deemed effective in reviews based on trials or natural experiments. All of these estimates are based on studies with major methodological limitations. These estimates may be upwardly biased due to the lack of blinding and overreporting of physical activity.

Abbreviations: MVPA: moderate to vigorous-intensity physical activity; PE: physical education.

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