Educational intervention: older students received 45-minute healthy living lesson from the leader weekly; older students paired with younger students and taught the lesson to the younger students in 30-minute sessions, 21 lessons taught, school-wide healthy living theme day. Physical intervention: pairs participated in 30-min aerobic circuits twice a week and were encouraged to engage vigorously
Educational intervention: 8 lessons of HE education for students lasting 90 minutes each. Physical intervention: PE teachers were trained to increased time in PE as well as increased MVPA during PE. Parental involvement: motivational, instructional meetings with parents totaling 45 minutes
Educational intervention: teacher training; weekly lessons lasting 60 minutes of healthy lifestyle curriculum with HE and PA topics. Parental involvement: homework assignments involving parents
Environmental intervention: local media campaign, running event promotion. Educational intervention: HE and PA components across the curriculum, interactive website. Physical intervention: PE centered around running. Parental involvement: an interactive website was available to parents highlighting the importance of HE and PA, child homework assignments to be completed with parents, information and child PA planner provided
19
England, southwest
Kipping et al., 2014, Active for Life Year 5 (AFLY5) [40]
2123
6
Social Cognitive Theory
Teachers
RCT
ED, PI
Educational intervention: 16 lesson plans for PA and HE were delivered over the course of 2-3 school terms. Information on HE and PA was provided to schools intended for newsletters. Parental involvement: interactive homework assignments were given intended to be completed with parents and other family members; information on HE and PA was provided to schools intended for parents
Environmental intervention: access to playgrounds. Fruits and fresh fruit juice were available in the school canteen. Educational intervention: cross-curricular approach across science, environmental, and PE curriculums; 1-2 hours each week and covered HE and PA topics. Approaches utilized to facilitate behaviour change are discussion, active learning, cues, modelling, guided practice, enactment, problem solving, goal setting, self-reevaluation, environmental reevaluation, arguments, direct experience, and mobilizing social support. Physical intervention: two 45-minute activity sessions during PE each week at a moderate intensity with a focus on fun. Parental involvement: take home assignments to be completed with guardians; parents were encouraged to make fruit and fresh fruit juice available at home; school events involving the family were also held as tasting sessions of different fruits and vegetables
Theory of Planned Behaviour; Ecological Model of Egger and Swinburn
Teachers/PE teachers
RCT
ED, P, and PI
Educational intervention: health education curriculum including 3 lessons focused on HE, active living, and healthy lifestyle choices. Physical intervention: 3 PE lessons a week taught by a PE teacher; additional activities and sports coordinated with local sports clubs were offered outside school hours on a volunteer basis. Parental involvement: a fitness report card was sent home to parents including child’s weight status, as well as annual health promotion events with local sports clubs
Environmental intervention: installed water coolers; new sport and games equipment being supplied; and discouraged SSBs and encouraged intake of fruits and vegetables. Physical intervention: encouraged PA at lunch, recess, and after school through introduction of new games, sports, and activities. Resources were given to teachers to incorporate activity in class
Teachers, supported by exercise and nutrition specialists
RCT
EN, ED, P, and PI
Environmental intervention: specialists promoted active transport, active lunch, and peer leadership of PA outside of school; modifications to the canteen were made to provide healthier snacks; healthy fundraising options were also provided to teachers. Educational intervention: children received classroom lessons on HE during the same 3 weeks their parents attended nutrition sessions. Physical intervention: specialists supported teachers by modelling fundamental movement skills, ball games, fitness activities, and sport games and emphasized keeping all children moving throughout the sessions; teachers were also supported on how to manage children during activity sessions. Parental involvement: 3 information sessions were delivered to parents which included a practical nutrition session
19
Norway, southeast
Grydeland et al., 2013, Grydeland et al., 2014, and Bergh et al., 2012, HEIA [28–30]
1528
20
Social Ecological Theory
Teachers
RCT
EN, ED, P, and PI
Environmental intervention: active commute to school campaign, new sporting equipment. Educational intervention: classroom lessons about PA and dietary behaviours once a month; classroom posters; and computer programme for 7th graders regarding healthy behaviours. Physical intervention: weekly classroom PA breaks for 10 minutes, training of teachers for PE. Parental involvement: parent information sheet
Educational intervention: nutrition intervention with a PA education component; teachers trained by researchers (36 hours) on intervention delivery and delivery to students (36 hours). 12 lessons included topics such as HE for children, drinking water, fruit and vegetables, foods with low nutritional quality, PA, screen time, and cooking healthy meals
21
Spain, Reus, Cambrils, Salou, and Vila-seca
Tarro et al., 2014, Education in Alimentation (EdAl) [31]
1939
36
N/A
Undergraduate medical students
RCT
ED, PI
Educational intervention: 8 healthy lifestyle topics—advancing healthy lifestyles, drinking healthy drinks and avoiding SSBs, improving vegetable and legume intake, eating more fruits and nuts and decreasing high sugar/high fat snacks, promoting healthy habits (PA, home meals), and increasing fruit, dairy, and fish consumption; lessons were delivered in four 1-hour education and activity sessions each year over the course of 3 years for a total of 12 sessions and were not a part of the curriculum; corresponding booklets were used by teachers throughout the year. Parental involvement: similar activities children participated in that were included in the educational booklet children participated in were intended for parents also
Investigation, Vision, Action, and Change (IVAC) methodology
Teachers
RCT
EN, ED, and PI
Environmental intervention: sport/games equipment provided to school. Parental involvement: healthy recipes were given to families on a monthly basis as well as literature about local facilities and paths for physical activity
Environmental intervention: modifications were made to cafeteria food and vending machines to increase fruit and vegetables and decrease fat; the PA environmental component included changes to PE curriculum with aims of increasing MVPA to at least 60 minutes/day and decreasing screen time to <2 hours each day. Educational intervention: the environment + education group received an internet based education programme and classroom instruction during class time
Environmental intervention: modifications were made to cafeteria offerings of low-fat foods, low-fat nonflavoured milk, serve recommended portion sizes, increase fruit and vegetable availability and only gave 2nd helpings of fruit and vegetables; teachers limited snacks in the classroom to low-fat and low-sugar foods, and children were encouraged to drink water instead of SSBs. Physical intervention: each child received 60 minutes of PA each day during school hours (walks outside, modifications to PE, active classroom breaks, and active recess). Parental involvement: home environment, family nights, newsletters, and motivational telephone calls
22
RCT = randomised controlled trial. NRCT = nonrandomised controlled trial. EN = environmental. ED = educational. P = physical. PA = physical activity. HE = healthy eating. PI = parental involvement. = three different studies using the same dataset.
