Benefits of before-school physical activity programs currently have mixed evidence

1. In this study, limited evidence suggested that before school physical activity (PA) programs were positively associated with improved daily physical activity levels.

2. Associations between before school PA programs were indeterminate for physical health, learning and psychosocial outcomes.

Evidence Rating Level: 1 (Excellent)

Physical activity (PA) programs in schools play an important role in overall wellness of children and adolescents. To date, most research on PA outside of school hours have focused on the after-school period; however, before-school PA programs also have the potential of not only having PA benefits, but also aiding cognition and learning. Since the evidence thus far is limited, the aim of the present systematic review was to evaluate the impact of before school PA programs on children’s PA levels, health indicators and learning outcomes.

The present systematic review included 13 articles representing 10 unique studies between 2012-2020. Studies were included if they included developing children and/or adolescents, examined school-based PA programs delivered before the school day and its association with PA behaviors, physical health, learning behaviors and/or psychosocial well-being. Studies which examined before-school sport or active transport were excluded. Risk of bias was assessed using the Cochrane Collaboration Tools Revised Cochrane Risk of Bias Tool for Randomized Trials (RoB2) and Risk of Bias in Non-randomized studies of Interventions (ROBINS-I). Assessment of the evidence was done using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE).

Results demonstrated that although evidence was limited, there was an association between before-school PA programs with daily PA levels. Conversely, associations were indeterminate for physical health, learning related and psychosocial outcomes. However, the present study was limited by the high risk of bias across multiple studies. Nonetheless, this study represented the first in examining the effectiveness of before school PA programs on multiple health outcomes and highlighted key areas for further research.

Click to read the study in British Journal of Sports Medicine

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