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. 2023 Jan 10:26:100575.
doi: 10.1016/j.lanepe.2022.100575. eCollection 2023 Mar.

Effect of nationwide school policy on device-measured physical activity in Danish children and adolescents: a natural experiment

Natascha H Pedersen  1 , Anders Grøntved  1 , Jan C Brønd  1 , Niels C Møller  1 , Kristian T Larsen  1 , Birgit Debrabant  2   3 , Sofie Koch  4 , Jens Troelsen  4 , Søren Brage  5 , Jasper Schipperijn  4 , Jacob Hjelmborg  3 , Niels Wedderkopp  1 , Lars B Christiansen  4 , Peter L Kristensen  1
Affiliations

Effect of nationwide school policy on device-measured physical activity in Danish children and adolescents: a natural experiment

Natascha H Pedersen et al. Lancet Reg Health Eur. .

Abstract

Background: A new Danish school policy with a requirement for 45 min physical activity daily during school hours was introduced in 2014. The objective of this natural experiment was to evaluate the effect of this nationwide school policy on physical activity in Danish children and adolescents.

Methods: Four historical studies completed between 2009 and 2012 comprised the pre-policy study population. Post-policy data were collected in 2017/18. All post-policy schools were represented in the four pre-policy studies. Age-groups and seasons were matched. In total, 4816 children and adolescents aged 6-17 were included in the analyses (2346 pre-policy and 2470 post-policy). Children and adolescents were eligible if they had accelerometer measurements and did not have any physical disabilities preventing activity. Physical activity was measured by accelerometry. Main outcome was any bodily movement. Secondary outcomes were moderate to vigorous physical activity and overall movement volume (mean counts per minute).

Findings: The school policy interrupted a linear decreasing pre-policy trend in physical activity during school hours. All activity outcomes increased post-policy during a standardized school day (8:10 am-1 pm). Increases were more pronounced in the youngest children. Specifically, we observed a daily increase during a standardized school day in 2017/2018 of 14.2 min of movement (95% CI: 11.4-17.0, p < 0.001), 6.5 min of moderate to vigorous physical activity (95% CI: 4.7-8.3, P < 0.001), and 141.8 counts per minute (95% CI: 108.5-175.2, P < 0.001).

Interpretation: A national school policy may be an important strategy to increase physical activity during school hours among children and adolescents.

Funding: The Danish Foundation TrygFonden has funded the PHASAR project (ID 115606).

Keywords: Children and adolescents; Health policy; Physical activity; School policy.

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Conflict of interest statement

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/disclosure-of-interest/ and declare no conflict of interest. Århus University hospital, Neurochirurgical department made payment to BD's institution (i.e., to IMADA, University of Southern Denmark). Göteborgs universitet, Institut of clinical science, made payment to BD's institution (i.e., to IMADA, University of Southern Denmark). UK Medical Research Council and NIHR provided support for SB's institution (Program grant and Centre grant, respectively). Moreover, S.B. was invited speaker at Yonsei University at two symposia (pro rata academic speaker fee), and Nanyang Technical University Singapore supported travelling costs for S.B. for attending meetings with local researchers. J.S. is president for the International Society for Physical Activity and Health (ISPAH), which is an unpaid volunteer position.

Figures

Fig. 1
Fig. 1
Marginal means with 95% CI of pre- and post-policy movement, MVPA and CPM during a standardized school day (a–c) and during a full day (d–f). CPM: Mean counts per minute. MVPA: moderate to vigorous physical activity.
See this image and copyright information in PMC

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