Providing game equipment during recess periods was found to be effective in increasing children's physical activity levels. This finding suggests that promoting physical activity through game equipment provision during recess periods can contribute to reach the daily activity levels recommended for good health.

Objective: To evaluate the effects of a comprehensive physical activity (PA) promotion programme in elementary schools on children's total PA levels, leisure-time PA, physical fitness and psychosocial correlates of PA. Design: A pre-test -post-test design over two school years. Setting and subjects: Sixteen elementary schools (764 children, mean age: 11.2^0.7 years) were randomly assigned to the intervention condition (n ¼ 8) and the control condition (n ¼ 8). The intervention included a health-related physical education programme, an extracurricular PA promotion programme and classroom-based PA education lessons. In the total sample, leisure-time PA, psychosocial correlates of PA and physical fitness were measured using a PA questionnaire and the Eurofit test battery. In a sub-sample, total PA levels were measured using an accelerometer. Results: According to accelerometer data, children's moderate PA and moderate-tovigorous PA (MVPA) levels decreased less in the intervention schools than in the control schools (P , 0.01). The average time spent on MVPA decreased by 9 min per day in the intervention schools compared with 33 min per day in the control schools. Children in the intervention schools reported significantly more moderate PA in leisure time than the controls (P , 0.05). No overall improvement of physical fitness and no effects on the psychosocial correlates of PA were found. Conclusions: The comprehensive PA promotion programme was successful in preventing a decline in children's total activity levels. Furthermore, the intervention increased children's PA engagement in leisure time. Therefore, implementation needs to be encouraged.

Promoting a physically active lifestyle whilst optimizing the spinal load at a young age seems to be advocated within the scope of early back pain prevention efforts. The present study aimed at evaluating the effects of combining a back care program with a physical activity promotion program in elementary schoolchildren. In a pre-post design over two school years, back care knowledge, back care behavior, fear avoidance beliefs and back pain reports were evaluated in children classified into three categories--those who received a back care and a physical activity promotion program (n=190), those who received only a back care program (n=193) and those in a control group (n=172) (mean age at baseline: 9.7 years+/-0.7). Physical activity levels were evaluated in a sub-sample of 26 pupils in each group. The back care program and the physical activity promotion program were both comprehensive ones. In both intervention groups, the scores for back care related knowledge and back care behavior were significantly higher than the control group. The increase in the sum score for back care behavior was significantly higher in the back care group than in the back care plus physical activity promotion group. Significant interaction effects showed an increase in fear-avoidance beliefs between pre- and post-tests in the control group, significantly different from the better scores in both intervention groups. Interaction effects were not significant for pain reports. In the back care plus physical activity promotion group, the daily moderate to vigorous physical activity levels decreased by 8 min per day while a decrease by 31 min per day was found in the back care group and a decrease by 36 min per day in the control group. However, group differences were not significant. The present study findings favor the addition of a physical activity promotion program to a back care program in elementary schools within the scope of early back pain prevention efforts. However, the findings also emphasize the disadvantages of implementing both programs simultaneously in a school curriculum that is already full.

A moderate dietary restriction in combination with physical activity and psychological support in severely obese children and adolescents is effective in decreasing body fat and improving physical performance. Further research is needed to evaluate the longer-term effects of such a programme.

The study aim was to evaluate the effectiveness of a 2-year health-related physical education intervention in a pretest-posttest design. Sixteen elementary schools (764 pupils, mean age: 11.2 ± 0.7) participated in the study. Schools were randomly assigned to the intervention condition (n = 8) and the control condition (n = 8). Making use of direct observation data gathered according to SOFIT (System for Observing Fitness Instruction Time), the moderate-to-vigorous physical activity engagement during physical education classes was significantly higher in the intervention condition than in the control condition. Children’s moderate-to-vigorous physical activity engagement during physical education lessons increased with 14% in the intervention condition (from 42 to 56%). No significant effects were found on the accelerometer data. The health-related physical education intervention was found to be promising in promoting physical activity during physical education classes.