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Meta-Analysis
. 2024 Dec 12;12(12):CD011677.
doi: 10.1002/14651858.CD011677.pub4.

Strategies for enhancing the implementation of school-based policies or practices targeting diet, physical activity, obesity, tobacco or alcohol use

Daniel Cw Lee  1   2   3   4 , Kate M O'Brien  1   2   3   4 , Sam McCrabb  1   2   3   4 , Luke Wolfenden  1   2   3   4 , Flora Tzelepis  1   2 , Courtney Barnes  1   2   3   4 , Serene Yoong  4   5 , Kate M Bartlem  2   3   6 , Rebecca K Hodder  1   2   3   4
Affiliations
Meta-Analysis

Strategies for enhancing the implementation of school-based policies or practices targeting diet, physical activity, obesity, tobacco or alcohol use

Daniel Cw Lee et al. Cochrane Database Syst Rev. .

Abstract

Background: A range of school-based interventions are effective in improving student diet and physical activity (e.g. school food policy interventions and classroom physical activity interventions), and reducing obesity, tobacco use and/or alcohol use (e.g. tobacco control programmes and alcohol education programmes). However, schools are frequently unsuccessful in implementing such evidence-based interventions.

Objectives: The primary review objective is to evaluate the effectiveness of strategies aiming to improve school implementation of interventions to address students' (aged 5 to 18 years) diet, physical activity, obesity, tobacco use and/or alcohol use. The secondary objectives are to: 1. determine whether the effects are different based on the characteristics of the intervention including school type and the health behaviour or risk factor targeted by the intervention; 2. describe any unintended consequences and adverse effects of strategies on schools, school staff or students; and 3. describe the cost or cost-effectiveness of strategies.

Search methods: We searched CENTRAL, MEDLINE (Ovid), Embase (Ovid), five additional databases, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the US National Institutes of Health registry (clinicaltrials.gov). The latest search was between 1 May 2021 and 30 June 2023 to identify any relevant trials published since the last published review.

Selection criteria: We defined 'implementation' as the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns within specific settings. We included any randomised controlled trial (RCT) or cluster-RCT conducted on any scale, in a school setting, with a parallel control group that compared a strategy to improve the implementation of policies or practices to address diet, physical activity, obesity, tobacco use and/or alcohol use by students (aged 5 to 18 years) to no active implementation strategy (i.e. no intervention, inclusive of usual practice, minimal support) or a different implementation strategy.

Data collection and analysis: We used standard Cochrane methods. Given the large number of outcomes reported, we selected and included the effects of a single outcome measure for each trial for the primary outcome using a decision hierarchy (i.e. continuous over dichotomous, most valid, total score over subscore). Where possible, we calculated standardised mean differences (SMDs) to account for variable outcome measures with 95% confidence intervals (CI). We conducted meta-analyses using a random-effects model. Where we could not combine data in meta-analysis, we followed recommended Cochrane methods and reported results in accordance with 'Synthesis without meta-analysis' (SWiM) guidelines. We conducted assessments of risk of bias and evaluated the certainty of evidence (GRADE approach) using Cochrane procedures.

Main results: We included an additional 14 trials in this update, bringing the total number of included trials in the review to 39 trials with 83 trial arms and 6489 participants. Of these, the majority were conducted in Australia and the USA (n = 15 each). Nine were RCTs and 30 were cluster-RCTs. Twelve trials tested strategies to implement healthy eating practices; 17 physical activity, two tobacco, one alcohol, and seven a combination of risk factors. All trials used multiple implementation strategies, the most common being educational materials, educational meetings, and education outreach visits, or academic detailing. Of the 39 included trials, we judged 26 as having high risks of bias, 11 as having some concerns, and two as having low risk of bias across all domains. Pooled analyses found, relative to a control (no active implementation strategy), the use of implementation strategies probably results in a large increase in the implementation of interventions in schools (SMD 0.95, 95% CI 0.71, 1.19; I2 = 78%; 30 trials, 4912 participants; moderate-certainty evidence). This is equivalent to a 0.76 increase in the implementation of seven physical activity intervention components when the SMD is re-expressed using an implementation measure from a selected included trial. Subgroup analyses by school type and targeted health behaviour or risk factor did not identify any differential effects, and only one study was included that was implemented at scale. Compared to a control (no active implementation strategy), no unintended consequences or adverse effects of interventions were identified in the 11 trials that reported assessing them (1595 participants; moderate-certainty evidence). Nine trials compared costs between groups with and without an implementation strategy and the results of these comparisons were mixed (2136 participants; low-certainty evidence). A lack of consistent terminology describing implementation strategies was an important limitation of the review.

Authors' conclusions: We found the use of implementation strategies probably results in large increases in implementation of interventions targeting healthy eating, physical activity, tobacco and/or alcohol use. While the effectiveness of individual implementation strategies could not be determined, such examination will likely be possible in future updates as data from new trials can be synthesised. Such research will further guide efforts to facilitate the translation of evidence into practice in this setting. The review will be maintained as a living systematic review.

Trial registration: ClinicalTrials.gov NCT03119415.

PubMed Disclaimer

Conflict of interest statement

Some members of the review team are currently undertaking a series of randomised trials aiming to facilitate the implementation of healthy eating and physical activity policies and practices by schools (LW, CB, KO, RKH, SY). Authors LW, SY and RKH are authors on one or more of the trials conducted in Australia. For such trials, eligibility, data extraction, risk of bias assessment, and GRADE assessment were carried out by review authors who were not directly involved in these studies; this is in line with the Cochrane Conflict of Interests Policy. The authors have not received any benefit, in cash or kind, any hospitality, or any subsidy derived from any source perceived to have an interest in the outcome of the review. All authors have contributed to the development of evaluation of trials examining the impact of implementation strategies in community settings, including those conducted in schools.

LW is Co‐ordinating Editor, SMc is Assistant Managing Editor and Method Editor, KO is a Method Editor for Cochrane Public Health, and RKH is a Cochrane Public Health Research Associate. LW, SMc and KO were not involved in any stage of the editorial management or assessment of this review.

DL: no other conflicts of interest

KO: no other conflicts of interest

LW: no other conflicts of interest

SMc: no other conflicts of interest

FT: no other conflicts of interest

CB: no other conflicts of interest

SY: no other conflicts of interest

KB: no other conflicts of interest

RKH: no other conflicts of interest

Figures

1
1
Screen4Me summary diagram. Figure provided by Screen4Me
2
2
Study flow diagram
3
3
Frequency of different implementation strategies across all included trials. Figure created using Microsoft Excel, by review author
4
4
Funnel plot for primary outcome (implementation)
1.1
1.1. Analysis
Comparison 1: Impact of implementation strategy versus no active implementation strategy, Outcome 1: Implementation outcome
2.1
2.1. Analysis
Comparison 2: Sensitivity analyses, Outcome 1: Excluding overall high risk of bias
2.2
2.2. Analysis
Comparison 2: Sensitivity analyses, Outcome 2: ICC 0.07
2.3
2.3. Analysis
Comparison 2: Sensitivity analyses, Outcome 3: ICC 0.351
2.4
2.4. Analysis
Comparison 2: Sensitivity analyses, Outcome 4: Adjusting for clustering where the unit of analysis was unclear
2.5
2.5. Analysis
Comparison 2: Sensitivity analyses, Outcome 5: Including trials that explicitly described a trial aim or objective to test the effectiveness of an implementation strategy on an implementation outcome
3.1
3.1. Analysis
Comparison 3: Subgroup analyses, Outcome 1: School type
3.2
3.2. Analysis
Comparison 3: Subgroup analyses, Outcome 2: Targeted health behaviour or risk factor
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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Hager 2018 {published data only}
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Hodder 2017 {published data only}
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Koorts 2022 {published data only}
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Lane 2022 {published data only}
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Nathan 2021 {published data only}ACTRN12617001265369
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Perry 1997 {published data only}
    1. Edmundson EW, Luton SC, McGraw SA, Kelder SH, Layman AK, Smyth MH, et al. CATCH: classroom process evaluation in a multicenter trial. Health Education & Behavior 1994;21(S1):S27-50. - PubMed
    1. Luepker RV, Perry CL, McKinlay SM, Nader PR, Parcel GS, Stone EJ, et al. Outcomes of a field trial to improve children's dietary patterns and physical activity: the Child and Adolescent Trial for Cardiovascular Health (CATCH). JAMA 1996;275(10):768-76. - PubMed
    1. Luepker RV, Perry CL, Osganian V, Nader PR, Parcel GS, Stone EJ, et al. The child and adolescent trial for cardiovascular health (CATCH). Journal of Nutritional Biochemistry 1998;9(9):525-34.
    1. Lytle LA, Johnson CC, Bachman K, Wambsgans K, Perry CL, Stone EJ, et al. Successful recruitment strategies for school-based health promotion: experiences from CATCH. Journal of School Health 1994;64(10):405-9. - PubMed
    1. Lytle LA, Stone EJ, Nichaman MZ, Perry CL, Montgomery DH, Nicklas TA, et al. Changes in nutrient intakes of elementary school children following a school-based intervention: results from the CATCH Study. Preventive Medicine 1996;25(4):465-77. - PubMed
Perry 2004 {published data only}
    1. Perry CL, Bishop DB, Taylor GL, Davis M, Story M, Gray C, et al. A randomized school trial of environmental strategies to encourage fruit and vegetable consumption among children. Health Education & Behavior 2004;31(1):65-76. - PubMed
Saraf 2015 {published data only}
    1. Saraf DS, Gupta SK, Pandav CS, Nongkinrih B, Kapoor SK, Pradhan SK, et al. Effectiveness of a school based intervention for prevention of non-communicable diseases in middle school children of rural North India: a randomized controlled trial. Indian Journal of Pediatrics 2015;82(4):354-62. - PubMed
Saunders 2006 {published data only}
    1. Pate RR, Ward DS, Saunders RP, Felton G, Dishman RK, Dowda M. Promotion of physical activity among high-school girls: a randomized controlled trial. American Journal of Public Health 2005;95(9):1582-7. - PMC - PubMed
    1. Saunders RP, Ward D, Felton GM, Dowda M, Pate RR. Examining the link between program implementation and behavior outcomes in the Lifestyle Education for Activity Program (LEAP). Evaluation and Program Planning 2006;29(4):352-64. - PubMed
    1. Ward DS, Saunders R, Felton GM, Williams E, Epping JN, Pate RR. Implementation of a school environment intervention to increase physical activity in high school girls. Health Education Research 2006;21(6):896-910. - PubMed
Story 2000 {published data only}
    1. Perry CL, Bishop DB, Taylor G, Murray DM, Mays RW, Dudovitz BS, et al. Changing fruit and vegetable consumption among children: the 5-a-Day Power Plus program in St. Paul, Minnesota. American Journal of Public Health 1998;88(4):603-9. - PMC - PubMed
    1. Story M, Mays RW, Bishop DB, Perry CL, Taylor G, Smyth M, et al. 5-a-day Power Plus: process evaluation of a multicomponent elementary school program to increase fruit and vegetable consumption. Health Education & Behavior 2000;27(2):187-200. - PubMed
Sturm 2021 {published data only}
    1. Demetriou Y, Bachner J. A school-based intervention based on self-determination theory to promote girls' physical activity: study protocol of the CReActivity cluster randomised controlled trial. BMC Public Health 2019;19(1):519. [DOI: 10.1186/s12889-019-6817-y] - DOI - PMC - PubMed
    1. Sturm DJ, Bachner J, Renninger D, Haug S, Demetriou Y. A cluster randomized trial to evaluate need-supportive teaching in physical education on physical activity of sixth-grade girls: a mixed method study. Psychology of Sport and Exercise 2021;54:10192. [DOI: 10.1016/j.psychsport.2021.101902] - DOI
Sutherland 2017 {published and unpublished data}
    1. Sutherland RL, Nathan NK, Lubans DR, Cohen K, Davies LJ, Desmet C, et al. An RCT to facilitate implementation of school practices known to increase physical activity. American Journal of Preventive Medicine 2017;53(6):818-28. - PubMed
Sutherland 2021 {published data only}
    1. Mclaughlin M, Duff J, Sutherland R, Campbell E, Wolfenden L, Wiggers J. Protocol for a mixed methods process evaluation of a hybrid implementation-effectiveness trial of a scaled-up whole-school physical activity program for adolescents: Physical Activity 4 Everyone (PA4E1). Trials 2020;21:268. - PMC - PubMed
    1. Sutherland R, Campbell E, McLaughlin M, Nathan N, Wolfenden L, Lubans DR, et al. Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 12-month implementation outcomes from a cluster randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity 2020;17(1):1-4. - PMC - PubMed
    1. Sutherland R, Campbell E, McLaughlin M, Nathan N, Wolfenden L, Lubans DR, et al. Scale-up of the Physical Activity 4 Everyone (PA4E1) intervention in secondary schools: 24-month implementation and cost outcomes from a cluster randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity 2021;18(1):137. [DOI: 10.1186/s12966-021-01206-8] - DOI - PMC - PubMed
    1. Sutherland R, Campbell E, Nathan N, Wolfenden L, Lubans DR, Morgan PJ, et al. A cluster randomised trial of an intervention to increase the implementation of physical activity practices in secondary schools: study protocol for scaling up the Physical Activity 4 Everyone (PA4E1) program. BMC Public Health 2019;19(1):883. - PMC - PubMed
Van Ryzin 2018 {published data only}
    1. Van Ryzin MJ, Cil G, Roseth CJ. Costs and benefits of cooperative learning as a universal school-based approach to adolescent substance use prevention. Journal of Community Psychology 2023;51(1):438-52. [DOI: 10.1002/jcop.22916] - DOI - PMC - PubMed
    1. Van Ryzin MJ, Roseth CJ. Cooperative learning effects on peer relations and alcohol use in middle school. Journal of Applied Developmental Psychology 2019;64:101059. [DOI: 10.1016/j.appdev.2019.101059] - DOI - PMC - PubMed
    1. Van Ryzin MJ, Roseth CJ. Cooperative learning in middle school: a means to improve peer relations and reduce victimization, bullying, and related outcomes. Journal of Educational Psychology 2018;110(8):1192-201. [DOI: 10.1037/edu0000265] - DOI - PMC - PubMed
    1. Van Ryzin MJ, Roseth CJ. Enlisting peer cooperation in the service of alcohol use prevention in middle school. Child Development 2017;89(6):459-67. [DOI: 10.1111/cdev.12981] - DOI - PMC - PubMed
    1. Van Ryzin MJ, Roseth CJ. Peer influence processes as mediators of effects of a middle school substance use prevention program. Addictive Behaviors 2018;85:180-5. [DOI: 10.1016/j.addbeh.2018.06.016] - DOI - PMC - PubMed
Waters 2017 {published data only}
    1. Waters E, Gibbs L, Tadic M, Ukoumunne OC, Magarey A, Okely AD, et al. Cluster randomised trial of a school-community child health promotion and obesity prevention intervention: findings from the evaluation of Fun 'n Healthy in Moreland! BMC Public Health 2017;18(1):92. [DOI: 10.1186/s12889-017-4625-9] - DOI - PMC - PubMed
Wolfenden 2017 {published data only}
    1. Reilly KL, Reeves P, Deeming S, Yoong SL, Wolfenden L, Nathan N, et al. Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness. BMC Public Health 2018;18:378. - PMC - PubMed
    1. Wolfenden L, Nathan N, Janssen LM, Wiggers J, Reilly K, Delaney T. Multi-strategic intervention to enhance implementation of healthy canteen policy: a randomised controlled trial. Implementation Science 2017;12(1):6. - PMC - PubMed
    1. Wolfenden L, Nathan N, Williams CM, Delaney T, Reilly KL, Freund M. A randomised controlled trial of an intervention to increase the implementation of a healthy canteen policy in Australian primary schools: study protocol. Implementation Science 2014;9(1):147. - PMC - PubMed
Wright 2019 {published data only}
    1. Sacheck JM, Wright CM, Amin SA, Anzman-Frasca S, Chomitz VM, Chui KK, et al. The fueling learning through exercise study cluster RCT: impact on children's moderate-to-vigorous physical activity. American Journal of Preventive Medicine 2021;60(6):239-49. [DOI: 10.1016/j.amepre.2021.01.002] - DOI - PMC - PubMed
    1. Wright C, Chomitz V, Duquesnay P, Amin S, Economos C, Sacheck J. The FLEX study school-based physical activity programs - measurement and evaluation of implementation. BMC Public Health 2019;19:73. [DOI: 10.1186/s12889-018-6335-3] - DOI - PMC - PubMed
    1. Wright C, Duquesnay P, Anzman-Frasca S, Chomitz V, Chui K, Economos C, et al. Study protocol: the Fueling Learning through Exercise (FLEX) study - a randomized controlled trial of the impact of school-based physical activity programs on children's physical activity, cognitive function, and academic achievement. BMC Public Health 2016;16(1):1078-8. [DOI: 10.1186/s12889-016-3719-0] - DOI - PMC - PubMed
Wyse 2021 {published data only}
    1. Wyse R, Delaney T, Gibbins P, Ball K, Campbell K, Yoong SL, et al. Cluster randomised controlled trial of an online intervention to improve healthy food purchases from primary school canteens: a study protocol of the 'Click & Crunch' trial. BMJ Open 2019;9(9):e030538. - PMC - PubMed
    1. Wyse R, Delaney T, Stacey F, Zoetemeyer R, Lecathelinais C, Lamont H, et al. Effectiveness of a multistrategy behavioral intervention to increase the nutritional quality of primary school students' web-based canteen lunch orders (Click & Crunch): cluster randomized controlled trial. Journal of Medical Internet Research 2021;23(9):26054. [DOI: 10.2196/26054] - DOI - PMC - PubMed
Yoong 2016 {published data only}
    1. Reilly KL, Reeves P, Deeming S, Yoong SL, Wolfenden L, Nathan N, et al. Economic analysis of three interventions of different intensity in improving school implementation of a government healthy canteen policy in Australia: costs, incremental and relative cost effectiveness. BMC Public Health 2018;18:378. - PMC - PubMed
    1. Williams CM, Nathan N, Delaney T, Yoong SL, Wiggers J, Preece S. CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: protocol of a randomised controlled trial. BMJ Open 2015;5(6):e006969. - PMC - PubMed
    1. Yoong SL, Nathan N, Wolfenden L, Wiggers J, Reilly K, Oldmeadow C. CAFÉ: a multicomponent audit and feedback intervention to improve implementation of healthy food policy in primary school canteens: a randomised controlled trial. International Journal of Behavioral Nutrition and Physical Activity 2016;13(1):126. - PMC - PubMed
Young 2008 {published data only}
    1. Elder JP, Lytle L, Sallis JF, Young DR, Steckler A, Simons-Morton D. A description of the social-ecological framework used in the Trial of Activity for Adolescent Girls (TAAG). Health Education Research 2007;22(2):155-65. - PMC - PubMed
    1. Elder JP, Shuler L, Moe SG, Grieser M, Pratt C, Cameron S. Recruiting a diverse group of middle school girls into the trial of activity for adolescent girls. Journal of School Health 2008;78(10):523-31. - PMC - PubMed
    1. Stevens J, Murray DM, Catellier DJ, Hannan PJ, Lytle LA, Elder JP, et al. Design of the trial of activity in adolescent girls (TAAG). Contemporary Clinical Trials 2005;26(2):223-33. - PMC - PubMed
    1. Webber LS, Catellier DJ, Lytle LA, Murray DM, Pratt CA, Young DR, et al. Promoting physical activity in middle school girls: Trial of Activity for Adolescent Girls. American Journal of Preventive Medicine 2008;34(3):173-84. - PMC - PubMed
    1. Young DR, Steckler A, Cohen S, Pratt C, Felton G, Moe SG. Process evaluation results from a school- and community-linked intervention: the Trial of Activity for Adolescent Girls (TAAG). Health Education Research 2008;23(6):976-86. - PMC - PubMed

References to studies excluded from this review

Abdul 2022 {published data only}
    1. Abdul Halim NA, Wee LH, Mohd Saat NZ, Jit Singh SJ, Siau CS, Chan CM. Application of the logic model to the school-based Fit and Smart adolescent smoking cessation programme. Malaysian Journal of Medical Science 2022;29(5):133-45. [DOI: 10.21315/mjms2022.29.5.14] - DOI - PMC - PubMed
ACTRN12622000878774 {published data only}
    1. ACTRN12622000878774. 'Adventure and Veg' - the effectiveness of a parental text message and social media program on primary-school aged children's physical activity and vegetable eating behaviours; a randomised, controlled trial (pilot study). https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12622000878774 (first registered 21 June 2022).
Altermann 2023 {published data only}
    1. Altermann W, Gropel P. Effects of acute endurance, strength, and coordination exercise interventions on attention in adolescents: a randomized controlled study. Psychology of Sport and Exercise 2023;64:102300. [DOI: 10.1016/j.psychsport.2022.102300] - DOI - PubMed
Arlinghaus 2021 {published data only}
    1. Arlinghaus KR, O'Connor DP, Ledoux TA, Hughes SO, Johnston CA. A staged approach to address youth unresponsive to initial obesity intervention: a randomized clinical trial. International Journal of Obesity 2021;45(12):2585-90. [DOI: 10.1038/s41366-021-00940-0] - DOI - PMC - PubMed
Arnaiz 2023 {published data only}
    1. Arnaiz P, Seelig H, Gerber M, Adams L, Degen J, Dolley D, et al. Intervention effects and long-term changes in physical activity and cardiometabolic outcomes among children at risk of noncommunicable diseases in South Africa: a cluster-randomized controlled trial and follow-up analysis. Frontiers in Public Health 2023;11:1199381. [DOI: 10.3389/fpubh.2023.1199381] - DOI - PMC - PubMed
Aurino 2023 {published data only}
    1. Aurino E, Gelli A, Adamba C, Osei-Akoto I, Alderman H. Food for thought? Experimental evidence on the learning impacts of a large-scale school feeding program. Journal of Human Resources 2023;58(1):74. [DOI: 10.3368/jhr.58.3.1019-10515R1] - DOI
Boat 2022 {published data only}
    1. Boat R, Cooper SB, Carlevaro F, Magno F, Bardaglio G, Musella G, et al. 16 weeks of physically active mathematics and English language lessons improves cognitive function and gross motor skills in children aged 8-9 years. International Journal of Environmental Research and Public Health 2022;19:no pagination. [DOI: 10.3390/ijerph192416751] - DOI - PMC - PubMed
Cao 2022 {published data only}
    1. Cao M, Tang Y, Zou Y. Integrating high-intensity interval training into a school setting improve body composition, cardiorespiratory fitness and physical activity in children with obesity: a randomized controlled trial. Journal of Clinical Medicine 2022;11(18):5436. [DOI: 10.3390/jcm11185436] - DOI - PMC - PubMed
Costarelli 2022 {published data only}
    1. Costarelli V, Michou M, Svoronou E, Koutava N, Symvoulidou M, Anastasiou K, et al. 'Healthy Children, Healthy Planet': a pilot school-based educational intervention. Health Education Journal 2022;81(2):183-95. [DOI: 10.1177/00178969211062479] - DOI
Crotti 2022 {published data only}
    1. Crotti M, Rudd J, Roberts S, Fitton Davies K, O'Callaghan L, Utesch T, et al. Physical activity promoting teaching practices and children's physical activity within physical education lessons underpinned by motor learning theory (SAMPLE-PE). PloS One 2022;17(8):e0272339. [DOI: 10.1371/journal.pone.0272339] - DOI - PMC - PubMed
Emonson 2022 {published data only}
    1. Emonson C, Papadopoulos N, Rinehart N, Mantilla A, Fuelscher I, Boddy LM, et al. The feasibility and acceptability of a classroom-based physical activity program for children attending specialist schools: a mixed-methods pilot study. BMC Public Health 2022;22(1):40. [DOI: 10.1186/s12889-021-11990-4] - DOI - PMC - PubMed
Espinoza 2023 {published data only}
    1. Espinoza M, Latorre A, Cabrera C, Parraga Montilla JA, Martinez C. Effects of a high intensity interval training (HIIT) program on anthropomorphic and cardiometabolic variables in school children with overweight and obesity. Children 2023;10(2):317. [DOI: 10.3390/children10020317] - DOI - PMC - PubMed
Godoy‐Cumillaf 2022 {published data only}
    1. Godoy-Cumillaf A, Fuentes-Merino P, Giakoni-Ramirez F, Duclos-Bastias D, Merellano-Navarro E. Effectiveness of a physical activity intervention on the overweight and obesity of Chilean schoolchildren. Medicine 2022;101(39):e30908. [DOI: 10.1097/MD.0000000000030908] - DOI - PMC - PubMed
Guillou‐Landreat 2021 {published data only}
    1. Guillou-Landreat M, Tahmazov E, Benoit S, Grall-Bronnec M, Conrod P, Livet A, et al. The efficacy of a targeted PREVENTION programme for addictive behaviour (PREVENTURE) among vulnerable ADOlescents in France - study procotol. BMC Public Health 2021;21(1):783. [DOI: 10.1186/s12889-021-10795-9] - DOI - PMC - PubMed
Guler 2023 {published data only}
    1. Guler R, Kublay G, Firat KH. The effectiveness of a nurse-led health development programme on fourth-grade school-age children in north Cyprus: a randomised-controlled trial. Health Education Journal 2023;82(2):169-83. [DOI: 10.1177/00178969221146429] - DOI
Haug 2021 {published data only}
    1. Haug S, Paz Castro R, Wenger A, Schaub MP. A mobile phone-based life-skills training program for substance use prevention among adolescents: cluster-randomized controlled trial. JMIR MHealth and UHealth 2021;9(7):e26951. [DOI: 10.2196/26951] - DOI - PMC - PubMed
Heiland 2022 {published data only}
    1. Heiland EG, Kjellenberg K, Tarassova O, Fernstrom M, Nyberg G, Ekblom MM, et al. ABBaH teens: activity Breaks for Brain Health in adolescents: study protocol for a randomized crossover trial. Trials 2022;23(1):22. [DOI: 10.1186/s13063-021-05972-5] - DOI - PMC - PubMed
ISRCTN34281561 {published data only}
    1. ISRCTN34281561. ‘Walk Buds’: a walking programme to increase physical activity, physical fitness and emotional wellbeing, in children aged 9-13 years with intellectual disability. https://www.isrctn.com/ISRCTN34281561 (first registered 21 February 2022). - PubMed
Jarraya 2022 {published data only}
    1. Jarraya S, Jarraya M, Nouira S. Effect of yoga on motor skills and self-esteem in kindergarten children: a randomized controlled trial. International Journal of Yoga Therapy 2022;32(2022):01. [DOI: 10.17761/2022-D-21-00060] - DOI - PubMed
Kable 2022 {published data only}
    1. Kable TJ, Leahy AA, Smith JJ, Eather N, Shields N, Noetel M, et al. Time-efficient physical activity intervention for older adolescents with disability: rationale and study protocol for the Burn 2 Learn adapted (B2La) cluster randomised controlled trial. BMJ Open 2022;12(8):e065321. [DOI: 10.1136/bmjopen-2022-065321] - DOI - PMC - PubMed
Komro 2022 {published data only}
    1. Komro KA, Kominsky TK, Skinner JR, Livingston MD, Livingston BJ, Avance K, et al. Study protocol for a cluster randomized trial of a school, family, and community intervention for preventing drug misuse among older adolescents in the Cherokee Nation. Trials 2022;23(1):175. [DOI: 10.1186/s13063-022-06096-0] - DOI - PMC - PubMed
Marsiglia 2022 {published data only}
    1. Marsiglia FF, Kulis SS, Cutrin O, Medina-Mora ME, Real T, Nuno-Gutierrez BL, et al. The feasibility, acceptability, and utility of mantente REAL: the culturally adapted version of keepin' it REAL for Mexico. Prevention Science 2022;23(8):1483-94. [DOI: 10.1007/s11121-022-01409-w] - DOI - PubMed
Meng 2022 {published data only}
    1. Meng C, Yucheng T, Shu L, Yu Z. Effects of school-based high-intensity interval training on body composition, cardiorespiratory fitness and cardiometabolic markers in adolescent boys with obesity: a randomized controlled trial. BMC Pediatrics 2022;22(1):1-11. [DOI: 10.1186/s12887-021-03079-z] - DOI - PMC - PubMed
Moura 2021 {published data only}
    1. Moura OM, Marinho DA, Forte P, Fail LB, Neiva HP. School-based swimming lessons enhance specific skills and motor coordination in children: the comparison between two interventions. Motricidade 2021;17(4):367-74.
NCT05182736 {published data only}
    1. NCT05182736. Taking responsible actions in life evaluation. https://clinicaltrials.gov/show/NCT05182736 (first posted 10 January 2022).
NCT05246852 {published data only}
    1. NCT05246852. The effect of training provided according to the health promotion model on healthy lifestyles and self-efficacy in adolescents. https://clinicaltrials.gov/show/NCT05246852 (first posted 18 February 2022).
NCT05455073 {published data only}
    1. NCT05455073. Evaluation of school-based nutrition intervention for adolescents in Bangladesh. https://clinicaltrials.gov/show/NCT05455073 (first posted 13 July 2022).
NCT05561192 {published data only}
    1. NCT05561192. Effects of inserting exercises during physical education classes on anxiety and depression symptoms in adolescents. https://clinicaltrials.gov/show/NCT05561192 (first posted 30 September 2022).
NCT05595161 {published data only}
    1. NCT05595161. Dissemination and implementation of the bright bodies intervention for childhood obesity. https://clinicaltrials.gov/NCT05595161 (first posted 26 October 2022).
NCT05764291 {published data only}
    1. NCT05764291. Digital intervention to improve physical activity behaviour in overweight and obese adolescents. https://clinicaltrials.gov/show/NCT05764291 (first posted 10 March 2023).
Newton 2022 {published data only}
    1. Newton NC, Debenham J, Slade T, Smout A, Grummitt L, Sunderland M, et al. Effect of selective personality-targeted alcohol use prevention on 7-year alcohol-related outcomes among high-risk adolescents: a secondary analysis of a cluster randomized clinical trial. JAMA Network Open 2022;5(11):e2242544. [DOI: 10.1001/jamanetworkopen.2022.42544] - DOI - PMC - PubMed
Omorou 2023 {published data only}
    1. Omorou AY, Manneville F, Achit H, Langlois J, Legrand K, Lecomte E, et al. Economic evaluation of a school-based strategy to prevent overweight and obesity in French adolescents: insights from the PRALIMAP randomised trial. Public Health 2023;215:75-85. [DOI: 10.1016/j.puhe.2022.11.025] - DOI - PubMed
Ortega 2022 {published data only}
    1. Ortega FB, Mora-Gonzalez J, Cadenas-Sanchez C, Esteban-Cornejo I, Migueles JH, Solis-Urra P, et al. Effects of an exercise program on brain health outcomes for children with overweight or obesity: the Activebrains randomized clinical trial. JAMA Network Open 2022;5(8):e2227893. [DOI: 10.1001/jamanetworkopen.2022.27893] - DOI - PMC - PubMed
Pamplona‐Cunha 2022 {published data only}
    1. Pamplona-Cunha H, Rosini N, Caetano R, Machado MJ, Da Silva EL. Lifestyle intervention in reducing cardiometabolic risk factors in students with dyslipidemia and abdominal obesity: a randomized study. International Journal of Cardiovascular Sciences 2022;35(1):68-79. [DOI: 10.36660/ijcs.20200286] - DOI
Pisinger 2020 {published data only}
    1. Pisinger VS, Hoffmann S, Rosing JA, Gronbaek M, Tolstrup JS, Thygesen L, et al. Study protocol for a cluster randomised controlled trial testing the effectiveness of the 'High schools High on life' intervention on reducing excessive drinking in Danish high schools. BMJ Open 2020;10(8):e038857. [DOI: 10.1136/bmjopen-2020-038857] - DOI - PMC - PubMed
    1. Pisinger VS, Hoffmann SH, Palsson L, Dalum P, Gronbaek MK, Tolstrup JS, et al. 'High schools high on life': development of an intervention to reduce excessive drinking in Danish high schools. Frontiers in Public Health 2020;8:435. [DOI: 10.3389/fpubh.2020.00435] - DOI - PMC - PubMed
Poon 2022 {published data only}
    1. Poon K. Effects of aerobic exercise and high-intensity interval training on the mental health of adolescents living in poverty: protocol for a randomized controlled trial. JMIR Research Protocols 2022;11(1):e34915. [DOI: 10.2196/34915] - DOI - PMC - PubMed
Ricci 2022 {published data only}
    1. Ricci JM, Currie KD, Astorino TA, Erickson K, Pfeiffer KA. Program evaluation and preliminary efficacy of fitness and skill-based high-intensity interval training in physical education. Research Quarterly for Exercise and Sport 2022;94:1042–52. [DOI: 10.1080/02701367.2022.2110557] - DOI - PubMed
Ruiter 2022 {published data only}
    1. Ruiter EL, Molleman GR, Kleinjan M, Kraiss JT, Ten Klooster PM, Van der Velden K, et al. The effectiveness of a web-based Dutch parenting program to prevent overweight in children 9-13 years of age: results of a two-armed cluster randomized controlled trial. PloS One 2022;17(10):e0276168. [DOI: 10.1371/journal.pone.0276168] - DOI - PMC - PubMed
Saavedra‐Garcia 2022 {published data only}
    1. Saavedra-Garcia L, Moscoso-Porras M, Diez-Canseco F. An experimental study evaluating the influence of front-of-package warning labels on adolescent’s purchase intention of processed food products. International Journal of Environmental Research and Public Health 2022;19(3):1094. [DOI: 10.3390/ijerph19031094] - DOI - PMC - PubMed
Salahshoornezhad 2022 {published data only}
    1. Salahshoornezhad S, Sohrabi Z, Mani A, Abdelbasset WK, Mehrabi M, Zare M, et al. Effect of a multi-disciplinary program on anthropometric and biochemical parameters in obese and overweight elementary school girls: a randomized clinical trial. Nutrition, Metabolism and Cardiovascular Diseases 2022;32(8):1982-9. [DOI: 10.1016/j.numecd.2022.04.014] - DOI - PubMed
Sanchez 2021a {published data only}
    1. Sanchez ZM, Valente JY, Gusmoes JD, Ferreira-Junior V, Caetano SC, Cogo-Moreira H, et al. Effectiveness of a school-based substance use prevention program taught by police officers in Brazil: two cluster randomized controlled trials of the PROERD. International Journal of Drug Policy 2021;98:1-10. [DOI: 10.1016/j.drugpo.2021.103413] - DOI - PubMed
Srivastav 2021 {published data only}
    1. Srivastav P, Vaishali K, Bhat VH, Broadbent S. Structured, multifactorial randomised controlled intervention to investigate physical activity levels, body composition and diet in obese and overweight adolescents. BMJ Open 2021;11(3):e044895. [DOI: 10.1136/bmjopen-2020-044895] - DOI - PMC - PubMed
Troncoso 2021 {published data only}
    1. Troncoso P, Humphrey N. Playing the long game: a multivariate multilevel non-linear growth curve model of long-term effects in a randomized trial of the Good Behavior Game. Journal of School Psychology 2021;88:68-84. [DOI: 10.1016/j.jsp.2021.08.002] - DOI - PMC - PubMed
Valente 2022 {published data only}
    1. Valente JY, Cogo-Moreira H, Sanchez ZM. Applying a pattern-centered approach to assess the effect of a school-based drug use prevention program in Brazil: a cluster randomized controlled trial. Journal of Prevention 2022;43(4):529-48. [DOI: 10.1007/s10935-022-00681-4] - DOI - PubMed
Vishnupriya 2022 {published data only}
    1. Vishnupriya R, Srividya G, Kannan D, Anantharaj K. Impact of endurance training on cognitive development in primary school children. NeuroQuantology 2022;20(19):2438-46. [DOI: 10.48047/nq.2022.20.19.NQ99206] - DOI
White 2022 {published data only}
    1. White K, Lubans DR, Eather N. Feasibility and preliminary efficacy of a school-based health and well-being program for adolescent girls. Pilot and Feasibility Studies 2022;8:no pagination. [DOI: 10.1186/s40814-021-00964-3] - DOI - PMC - PubMed
Wong 2022 {published data only}
    1. Wong LS, Muirhead F, Powell E, Woodfield LA, Stewart C, Reilly JJ. Feasibility of an intervention for increasing moderate-to-vigorous intensity physical activity (MVPA) in primary school physical education: a study protocol. F1000Research 2022;11:no pagination. [DOI: 10.12688/f1000research.109096.2] - DOI
Zhou 2023 {published data only}
    1. Zhou L, Liang W, He Y, Duan Y, Rhodes RE, Lippke S, et al. A school-family blended multi-component physical activity program for Fundamental Motor Skills Promotion Program for Obese Children (FMSPPOC): protocol for a cluster randomized controlled trial. BMC Public Health 2023;23(1):369. [DOI: 10.1186/s12889-023-15210-z] - DOI - PMC - PubMed

References to studies awaiting assessment

ACTRN12622000600741 {published data only}12622000600741
    1. ACTRN12622000600741. Testing the effectiveness and implementation at scale of TransformUs program on physical activity and sitting time in Australian Secondary Schools. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12622000600741 (first registered 21 April 2022).
ACTRN12623000145606 {published data only}12623000145606
    1. ACTRN12623000145606. An evaluation into the state-wide scale up of a text message based healthy lunchbox program aimed at improving child nutrition. https://www.anzctr.org.au/ACTRN12623000145606 (first registered 13 February 2023).
ACTRN12623000548639 {published data only}12623000548639
    1. ACTRN12623000548639. An evaluation into the national scale-up of an effective text message based healthy lunchbox program aimed at improving child nutrition. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12623000548639 (first registered 23 May 2023).
ACTRN12623000558628 {published data only}12623000558628
    1. ACTRN12623000558628. Evaluating the effectiveness of scale up strategies tailored to local context on the adoption of a text message based lunchbox program to address poor dietary intake in primary school aged children. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12623000558628 (first registered 24 May 2023).
Judiono 2019 {published data only}
    1. Judiono, Ichwanuddin, Olifa N, Moesiyanti YE, Surmita, Purba A. Integrated nutrition interventions reduce metabolic syndrome: study of integrated interventions by diet, behavior, physical activity on overweight in Junior High school children in Bandung City. Annals of Nutrition & Metabolism 2019;75:388-8.
Kaschalk 2020 {published data only}27960182
    1. Kaschalk E. Evaluation of a Nutrition Curriculum Piloted in Indiana High Schools by Family and Consumer Sciences Teachers [PhD Thesis]. Indiana (US): Indiana University ProQuest Dissertations and Theses, 2020.
Mahajan 2021 {published data only}
    1. Mahajan A, Negi PC, Gandhi S, Sharma D, Grover N. Impact of school-based health behavioral intervention on awareness, practice pattern of healthy lifestyle, and cardiometabolic risk factors among school children of shimla: a cluster-randomized, intervention study. Indian Journal of Pediatrics 2021;89:343-50. [DOI: 10.1007/s12098-021-03786-6] - DOI - PubMed
NCT05048433 {published data only}05048433
    1. NCT05048433. Developing and testing an implementation strategy for active learning to promote physical activity in children. https://clinicaltrials.gov/show/NCT05048433 (first posted 17 September 2021).

References to ongoing studies

ACTRN12620000372987 {published data only}
    1. ACTRN12620000372987. A randomised trial of an intervention to sustain primary schools’ implementation of a state-wide physical activity policy. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378735 (first registered 17 March 2020).
ACTRN12621000510842 {published data only}
    1. ACTRN12621000510842. Is a low-intensity, low-cost implementation strategy (ePACE) as effective in increasing teachers’ implementation of classroom physical activity as the previously established Physically Active Children in Education (PACE) implementation intervention? https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12621000510842 (first registered 30 April 2021).
ACTRN12622000252718 {published data only}
    1. ACTRN12622000252718. Assessing the effectiveness of methods of inviting schools to implement a lunchbox nutrition program. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12622000252718 (first registered 11 February 2022).
ACTRN12622000406707 {published data only}
    1. ACTRN12622000406707. Evaluating the efficacy of a multi-component dissemination strategy on the adoption of a school-based lunchbox nutrition program on the NSW Mid North Coast Local Health District of New South Wales. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12622000406707 (first registered 9 March 2022).
ACTRN12622000861752 {published data only}
    1. ACTRN12622000861752. Identifying strategies to support implementation of the Resistance Training for Teens (RT for Teens) school-based health-related fitness program for adolescents. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12622000861752 (first registered 17 June 2022).
ACTRN12623000533695 {published data only}
    1. ACTRN12623000533695. Zesty Kids: studying the relationship between fruits, vegetables, and children’s mental well-being. https://trialsearch.who.int/Trial2.aspx?TrialID=ACTRN12623000533695 (first registered 19 May 2023).
Bustos 2016 {published data only}
    1. Bustos N, Olivares S, Leyton B, Cano M, Albala C. Impact of a school-based intervention on nutritional education and physical activity in primary public schools in Chile (KIND) programme study protocol: cluster randomised controlled trial. BMC Public Health 2016;16(1):1217-7. [DOI: 10.1186/s12889-016-3878-z] - DOI - PMC - PubMed
Debenham 2021 {published data only}
    1. Debenham J, Birrell L, Champion K, Newton N. Study protocol for a cluster randomised controlled trial of The Illicit Project, a digital, neuroscience-based substance use intervention for secondary school students. Contemporary Clinical Trials 2021;107:106467. [DOI: 10.1016/j.cct.2021.106467] - DOI - PubMed
Duarte 2023 {published data only}
    1. Duarte A, Martins J, Martins S, Augusto C, Silva MJ, Rosario R. Implementation of a healthy lifestyle program with children from primary schools with social vulnerabilities: the BeE-school. Obesity Facts 2023;16:197. [DOI: 10.1159/000530456] [CLINICALTRIALS: NCT05395364] - DOI
Elinder 2021 {published data only}
    1. Elinder LS, Wiklund CA, Norman A, Stattin NS, Andermo S, Patterson E, et al. IMplementation and evaluation of the school-based family support PRogram a Healthy School Start to promote child health and prevent OVErweight and obesity (IMPROVE) - study protocol for a cluster-randomized trial. BMC Public Health 2021;21(1):1630. [DOI: 10.1186/s12889-021-11663-2] - DOI - PMC - PubMed
Estevan 2023 {published data only}
    1. Estevan I, García-Massó X, Menescardi C, Ortega-Benavent N, Montalt-García S, Romero-Martínez J, et al. A classroom-based intervention to promote physical literacy in children: ALPHYL study protocol. Behavioral Sciences 2023;13(7):609. [DOI: 10.3390/bs13070609] - DOI - PMC - PubMed
Fernandez‐Jimenez 2019 {published data only}
    1. Fernandez-Jimenez R, Santos-Beneit G, Tresserra-Rimbau A, Bodega P, De Miguel M, De Cos-Gandoy A, et al. Rationale and design of the school-based SI! Program to face obesity and promote health among Spanish adolescents: a cluster-randomized controlled trial. American Heart Journal 2019;215:27-40. - PubMed
ISRCTN11371954 {published data only}
    1. ISRCTN11371954. VisezEau® (ReachforWater): a project to learn how to increase drinking of tap water and reduce drinking of bottled and sugary drinks among primary school children, with the aim of encouraging healthy weight and protecting the environment. https://trialsearch.who.int/Trial2.aspx?TrialID=ISRCTN11371954 (first registered 31 January 2020). [ICTRP: ISRCTN11371954]
ISRCTN99843102 {published data only}
    1. Castetbon K, Assakali W, Thiébaut I, Desbouys L. Decreasing consumption of sugar-sweetened beverages and Raising tap water consumption through Interventions based on Nutrition and sustainability for Kids: study protocol of the “DRINK” cluster randomised controlled trial. Trials 2023;24(1):611. [DOI: 10.1186/s13063-023-07643-z] - DOI - PMC - PubMed
Kajons 2018 {published data only}
    1. Kajons N, David M, Gowland-Ella J, Lewis P, Batchelor S. Thirsty? Choose Water! Behavioural interventions and water stations in secondary schools: a two-by-two factorial randomised controlled trial. BMC Public Health 2018;18(1):788-8. [DOI: 10.1186/s12889-018-5685-1] - DOI - PMC - PubMed
Lane 2018 {published data only}
    1. Lane HG, Deitch R, Wang Y, Black MM, Dunton GF, Aldoory L, et al. “Wellness Champions for Change,” a multi-level intervention to improve school-level implementation of local wellness policies: study protocol for a cluster randomized trial. Contemporary Clinical Trials 2018;75:29-39. [DOI: 10.1016/j.cct.2018.10.008] - DOI - PMC - PubMed
Leahy 2019 {published data only}
    1. Leahy A, Eather N, Smith J, Hillman C, Morgan P, Nilsson M, et al. School-based physical activity intervention for older adolescents: rationale and study protocol for the Burn 2 Learn cluster randomised controlled trial. BMJ Open 2019;9(5):e026029. [DOI: 10.1136/bmjopen-2018-026029] - DOI - PMC - PubMed
Little 2022 {published data only}
    1. Little MA, Pebley K, Reid T, Morris JD, Wiseman KP. Rationale, design, and methods for the development of a youth adapted brief tobacco intervention plus automated text messaging for high school students. Contemporary Clinical Trials 2022;119:106840. [DOI: 10.1016/j.cct.2022.106840] - DOI - PMC - PubMed
Liu 2021 {published data only}
    1. Liu Z, Gao P, Gao A, Lin Y, Feng X, Zhang F, et al. Effectiveness of a multifaceted intervention for prevention of obesity in primary school children in China: a cluster randomized clinical trial. JAMA Pediatrics 2021;176(1):214375. [DOI: 10.1001/jamapediatrics.2021.4375] - DOI - PMC - PubMed
    1. Liu Z, Wu Y, Niu WY, Feng X, Lin Y, Gao A, et al. A school-based, multi-faceted health promotion programme to prevent obesity among children: protocol of a cluster-randomised controlled trial (the DECIDE-Children study). BMJ Open 2019;9(11):e027902. - PMC - PubMed
    1. Lyu J, Liu Z, Zhou S, Feng X, Lin Y, Gao A, et al. Effect of a multifaceted intervention for childhood obesity on dietary quality and the mediating role of dietary quality in changes of adiposity indicators. Nutrients 2022;14:3272. [DOI: 10.1111/obr.13502] - DOI - PMC - PubMed
McKee 2021 {published data only}
    1. McKee KL, Ricci JM, Currie KD, Astorino TA, Erickson K, Pfeiffer KA. Program evaluation of fitness- and skill-based high-intensity interval training (hiit) in elementary school physical education (2021 ACSM Annual Meeting & World Congresses [virtual], June 1 -5, 2021). Medicine and Science in Sports and Exercise 2021;53:238-9. [DOI: 10.1249/01.mss.0000761820.13598.e1] - DOI
Nathan 2022 {published data only}
    1. Nathan N, McCarthy N, Hall A, Shoesmith A, Lane C, Jackson R, et al. Cluster randomised controlled trial to determine the impact of an activity enabling uniform on primary school student's fitness and physical activity: study protocol for the Active WeAR Everyday (AWARE) study. BMJ Open 2022;12(9):e064692. [DOI: 10.1136/bmjopen-2022-064692] - DOI - PMC - PubMed
NCT00061165 {published data only}
    1. NCT00061165. Obesity prevention in African American school children. https://clinicaltrials.gov/study/NCT00061165 (first posted 23 May 2003).
NCT04942431 {published data only}
    1. NCT04942431. REBIRTH active school 2.0. A school based physical activity program. https://clinicaltrials.gov/show/NCT04942431 (first posted 28 June 2021).
NCT05109351 {published data only}
    1. NCT05109351. Communication and marketing of school meals. https://clinicaltrials.gov/show/NCT05109351 (first posted 5 November 2021).
NCT05382975 {published data only}
    1. NCT05382975. A comprehensive trauma-sensitive approach to physical activity promotion in schools (CSPAP-T). https://clinicaltrials.gov/show/NCT05382975 (first posted 19 May 2022).
NCT05461703 {published data only}
    1. NCT05461703. Efficacy of a school-based obesity prevention program in Mexican schoolchildren: cluster randomized controlled trial. https://clinicaltrials.gov/show/NCT05461703 (first posted 18 July 2022).
NCT05867433 {published data only}
    1. NCT05867433. Strong teens for healthy schools change club: a civic engagement approach to improving physical activity and healthy eating environments. https://clinicaltrials.gov/show/NCT05867433 (first posted 22 May 2023).
Qi 2022 {published data only}
    1. Qi Y, Rong S, Liao K, Huo J, Lin Q, Hamzah SH. School gardening, cooking and sports participation intervention to improve fruits and vegetables intake and moderate-to-vigorous physical activity among Chinese children: study protocol for a cluster randomized controlled trial. International Journal of Environmental Research and Public Health 2022;19(21):28. [DOI: 10.3390/ijerph192114096] - DOI - PMC - PubMed
Rosenkranz 2023 {published data only}
    1. Rosenkranz RR, Dixon PM, Dzewaltowski DA, McLoughlin GM, Lee JA, Chen S, et al. A cluster-randomized trial comparing two SWITCH implementation support strategies for school wellness intervention effectiveness. Journal of Sport and Health Science 2023;12(1):87-96. [DOI: 10.1016/j.jshs.2021.12.001] - DOI - PMC - PubMed
Rudd 2020 {published data only}
    1. Rudd JR, Crotti M, Fitton-Davies K, O'Callaghan L, Bardid F, Utesch T, et al. Skill acquisition methods fostering physical literacy in early-physical education (SAMPLE-PE): rationale and study protocol for a cluster randomized controlled trial in 5-6-year-old children from deprived areas of North West England. Frontiers in Psychology 2020;11:1228. [DOI: 10.3389/fpsyg.2020.01228] - DOI - PMC - PubMed
Sagatun 2023 {published data only}
    1. Sagatun Å, Engell T, Brekke M, Sjølie H, Ekornes SM, Waldum-Grevboe KS, et al. Guideline evaluation and implementation mechanisms in school health services (GuideMe): protocol for a hybrid randomized factorial trial. BMC Health Services Research 2023;23(1):1259. [DOI: 10.1186/s12913-023-10179-2] - DOI - PMC - PubMed
Santos‐Beneit 2019 {published data only}
    1. Santos-Beneit G, Bodega P, De Miguel M, Rodríguez C, Carral V, Orrit X, et al. Rationale and design of the SI! Program for health promotion in elementary students aged 6 to 11 years: a cluster randomized trial. American Heart Journal 2019;210:9-17. [DOI: 10.1016/j.ahj.2018.12.011] - DOI - PubMed
Strömmer 2020 {published data only}
    1. Strömmer S, Barrett M, Woods-Townsend K, Baird J, Farrell D, Lord J, et al. Engaging adolescents in changing behaviour (EACH-B): a study protocol for a cluster randomised controlled trial to improve dietary quality and physical activity. Trials 2020;21(1):859. [DOI: 10.1186/s13063-020-04761-w] - DOI - PMC - PubMed
Sutherland 2021a {published data only}
    1. Sutherland R, Brown A, Nathan N, Yoong S, Janssen L, Chooi A, et al. A multicomponent mhealth-based intervention (SWAP IT) to decrease the consumption of discretionary foods packed in school lunchboxes: type I effectiveness-implementation hybrid cluster randomized controlled trial. Journal of Medical Internet Research 2021;23(6):e25256. [DOI: 10.2196/25256] - DOI - PMC - PubMed
Sutherland 2022 {published data only}
    1. Sutherland R, Jones J, Brown A, Barnes C, Nathan N, Lecathelinais C, et al. Can a school nutrition intervention have an impact on a child's whole day total energy intake? Obesity Reviews 2022;23:no pagination. [DOI: 10.1111/obr.13503] - DOI
UMIN000027702 {published data only}
    1. UMIN000027702. Creating a healthier nutrition environment in schools: the Health Promoting School Canteen intervention. https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R0000... (first disclosure of study information 21 June 2017).
Volk 2021 {published data only}
    1. Haible S, Volk C, Demetriou Y, Honer O, Thiel A, Trautwein U, et al. Promotion of physical activity-related health competence in physical education: study protocol for the GEKOS cluster randomized controlled trial. BMC Public Health 2019;19(1):396. - PMC - PubMed
    1. Volk C, Rosenstiel S, Demetriou Y, Krustrup P, Thiel A, Trautwein U, et al. Effects of a physical education intervention programme for ninth-graders on physical activity-related health competence: findings from the GEKOS cluster randomised controlled trial. Psychology of Sport and Exercise 2021;55:101923. [DOI: 10.1016/j.psychsport.2021.101923] - DOI
Wargers 2023 {published data only}
    1. Wargers A, Queral J, Molenberg FJ, Tarro L, Elphick CM, Kalogerakou E, et al. Citizen science to improve healthy and active living among adolescents in four European countries: a protocol of the cluster randomised controlled trial of the Science Engagement to Empower aDolescentS (SEEDS) project. BMJ Open 2023;13(5):e070169. [DOI: 10.1136/bmjopen-2022-070169] - DOI - PMC - PubMed
Wassenaar 2019 {published data only}
    1. Wassenaar TM, Wheatley CM, Beale N, Salvan P, Meaney A, Possee JB, et al. Effects of a programme of vigorous physical activity during secondary school physical education on academic performance, fitness, cognition, mental health and the brain of adolescents (Fit to Study): study protocol for a cluster-randomised trial. Trials 2019;20(1):189. [DOI: 10.1186/s13063-019-3279-6] - DOI - PMC - PubMed

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