Introduction: A vast majority of children and adolescents are physically inactive. As a result, high obesity rates and related diseases have made physical activity promotion a politically relevant topic. In order to form the basis for political decision making, evidence is required regarding the efficacy and effectiveness of interventions for physical activity promotion. In contrast to previous research, this systematic review of reviews targets three key settings (family and home, childcare, school), and is among the largest to have been conducted.Methods: A systematic review of reviews was conducted as part of a large-scale project to develop national recommendations for physical activity promotion in Germany. Six electronic databases were searched and inclusion criteria were defined. Two independent reviewers screened the titles and abstracts of potentially relevant literature. 213 reviews were identified and categorised by target group. A total of 74 reviews were identified dealing with children and adolescents. Each review underwent a quality assessment.Results: 39 reviews with the highest quality and relevance were analysed. Three reviews focused on the family and home setting, 4 on the childcare setting, 28 on the school setting and 4 on other settings. Evidence revealed the key role played by parents in promoting physical activity in children within each setting. Furthermore, evidence pointed toward the efficacy of multi-component interventions in the childcare and school setting. Several evidence-based intervention strategies were identified for childcare facilities and schools.Discussion: The review of reviews identified a number of promising strategies for PA promotion among children and adolescents. Among reviews, multi-component interventions in childcare facilities and schools stand out prominently. At the same time, the review of reviews indicated that there is still a lack of studies on the efficacy of interventions that go beyond the individual level. We recommend that future research should also target community and policy level interventions and interventions other than the school setting. In order to make more specific recommendations regarding the scale-up of promising intervention strategies, further knowledge about the effectiveness, health equity and cost effectiveness of interventions is needed.

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A comparison of the results with existing data on physical activity prevalence in the member states indicate some inconsistencies between studies which may be related to measurement problems, as well as to conceptual differences in the assessment of physical activity.

BackgroundDespite growing recognition of the need to promote physical activity, the existing evidence base on the cost-effectiveness of relevant interventions appears scant and scattered. This systematic review of reviews set out to take stock of the evidence on the cost-effectiveness of physical activity interventions.MethodsTen literature databases were systematically searched for available reviews on the cost-effectiveness of physical activity interventions, complemented by a hand search. Out of the 515 articles identified, 18 reviews met the inclusion criteria. A quality appraisal of the 18 reviews was undertaken.ResultsOf the 18 reviews, 4 contained information on the target group of children and adolescents, 12 on adults, 3 on older adults, and 6 on the general population. Across the reviews some intervention strategies were identified as being particularly cost-effective, including certain school-based interventions (children and adolescents), interventions using pedometers (adults), fall prevention programs (older people), mass media campaigns and environmental approaches (general population). However, for some of these approaches (e.g. mass media campaigns), the underlying evidence of being able to change physical activity behavior remains inconsistent.ConclusionAvailable evidence for the cost-effectiveness of physical activity interventions is scattered, but points towards the cost-effectiveness of certain interventions. Until this moment, cost-effectiveness has more often been studied for individual-level interventions. This is potentially due to some methodological challenges in assessing the cost-effectiveness of population-based interventions.

Results provide some indication for a positive relationship between physical activity, as assessed with the IPAQ, and self-rated health. That in most nations sufficient levels of physical activity were not positively related to self-rated health might be explained by difficulties in assessing moderate forms of physical activity, and also differences of the context (at home, for leisure, at work, for transportation) where physical activity takes place.

<b><i>Background:</i></b> Children are becoming less physically active as opportunities for safe active play, recreational activities, and active transport decrease. At the same time, sedentary screen-based activities both during school and leisure time are increasing. <b><i>Objectives:</i></b> This study aimed to evaluate physical activity (PA), screen time, and sleep duration of girls and boys aged 6–9 years in Europe using data from the WHO European Childhood Obesity Surveillance Initiative (COSI). <b><i>Method:</i></b> The fourth COSI data collection round was conducted in 2015–2017, using a standardized protocol that included a family form completed by parents with specific questions about their children’s PA, screen time, and sleep duration. <b><i>Results:</i></b> Nationally representative data from 25 countries was included and information on the PA behaviour, screen time, and sleep duration of 150,651 children was analysed. Pooled analysis showed that: 79.4% were actively playing for &#x3e;1 h each day, 53.9% were not members of a sport or dancing club, 50.0% walked or cycled to school each day, 60.2% engaged in screen time for &#x3c;2 h/day, and 84.9% slept for 9–11 h/night. Country-specific analyses of these behaviours showed pronounced differences, with national prevalences in the range of 61.7–98.3% actively playing for &#x3e;1 h/day, 8.2–85.6% were not members of a sport or dancing club, 17.7–94.0% walked or cycled to school each day, 32.3–80.0% engaged in screen time for &#x3c;2 h/day, and 50.0–95.8% slept for 9–11 h/night. <b><i>Conclusions:</i></b> The prevalence of engagement in PA and the achievement of healthy screen time and sleep duration are heterogenous across the region. Policymakers and other stakeholders, including school administrators and parents, should increase opportunities for young people to participate in daily PA as well as explore solutions to address excessive screen time and short sleep duration to improve the overall physical and mental health and well-being of children.

Background: Falls are common in physically active older people; however, most intervention studies have been targeted at frail older people. Objective: To evaluate the effectiveness of two intervention techniques for preventing falls in physically active community-dwelling older people. Methods: Two hundred and seventeen people (120 men and 97 women) aged between 70 and 90 years recruited from a health insurance company membership database were randomly allocated to receive either a psychomotor intervention focusing on body awareness, body experience and coordination, a fitness intervention focusing on functional skills, strength, endurance and flexibility, or no intervention (control group).The outcome measures wereprospective falls (number of fallers, number of multiple fallers, number of falls and falls rate) and measures of physical performance (Timed Up and Go Test, maximal step length, sit-to-stand time, normal and fast walking speed). Results: At the 4-month follow-up, significant improvements in the Timed Up and Go Test and sit-to-stand times were observed for both the psychomotor and fitness intervention groups. During the 12-month follow-up period, 39% of the participants fell at least once, and 19% fell on multiple occasions. The proportion of fallers in the fitness intervention group was 23% less than in the control group (RR = 0.77, 95% CI 0.60–0.97), but no significant reduction in falls was observed in the psychomotor intervention group. Conclusion: A fitness training program improves some aspects of physical performance and reduces falls by 23% in physically active older people.

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