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Collin A. Webster, Judith E. Rink, Russell L. Carson, Jongho Moon, and Karen Lux Gaudreault

graphics are in the public domain. PA = physical activity; PE = physical education. The CSPAP model has become a widely disseminated paradigm in the literature concerning whole-of-school approaches to youth PA promotion. A sufficient corpus of CSPAP scholarship has grown to warrant the publication of the

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Karen Milton, Nick Cavill, Anna Chalkley, Charlie Foster, Sjaan Gomersall, Maria Hagstromer, Paul Kelly, Tracy Kolbe-Alexander, Jacqueline Mair, Matthew McLaughlin, James Nobles, Lindsey Reece, Trevor Shilton, Ben J. Smith, and Jasper Schipperijn

investment area. The final content for each of the investments was agreed upon through consensus. The 8 investments are explained below and summarized in Figure  1 . Figure 1 — Eight Investments that Work for Physical Activity . Eight Investments That Work for Physical Activity 1. ‘Whole-of-School’ Programs

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Alejandra Jáuregui, Selene Pacheco-Miranda, Armando García-Olvera, and Emanuel Orozco-Núñez

The earlier in life this important health behavior can be ingrained, the greater the impact will be on lifelong health. Schools can play an important role in helping youth meet PA guidelines, 9 especially when taking a whole-of-school approach, 10 in which curricular quality physical education (QPE

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Laura B. Russ, Collin A. Webster, Michael W. Beets, and David S. Phillips


A “whole-of-school” approach is nationally endorsed to increase youth physical activity (PA). Aligned with this approach, comprehensive school physical activity programs (CSPAP) are recommended. Distinct components of a CSPAP include physical education (PE), PA during the school day (PADS), PA before/after school (PABAS), staff wellness (SW), and family/community engagement (FCE). The effectiveness of interventions incorporating multiple CSPAP components is unclear. A systematic review and meta-analysis were conducted examining the effectiveness of multicomponent interventions on youth total daily PA.


Electronic databases were searched for published studies that (1) occurred in the US; (2) targeted K–12 (5–18 years old); (3) were interventions; (4) reflected ≥ 2 CSPAP components, with at least 1 targeting school-based PA during school hours; and (5) reported outcomes as daily PA improvements. Standardized mean effects (Hedge’s g) from pooled random effects inverse-variance models were estimated.


Across 14 studies, 12 included PE, 5 PADS, 1 PABAS, 2 SW, and 14 FCE. No studies included all 5 CSPAP components. Overall, intervention impact was small (0.11, 95% CI 0.03–0.19).


As designed, there is limited evidence of the effectiveness of multicomponent interventions to increase youth total daily PA. Increased alignment with CSPAP recommendations may improve intervention effectiveness.

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Huda Al Siyabi, Ruth M. Mabry, Amal Al Siyabi, Moosa Al Subhi, and Karen Milton

playground markings, active classrooms, and guidelines on adopting a whole-of-school approach to physical activity promotion; and initiatives to improve the environment for physical activity including marking footpaths to indicate distance walked in the capital area and the production of guidelines on public

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Shannon C. Mulhearn, Pamela Hodges Kulinna, and Collin Webster

physical education lesson. The call to action from international public health organizations including the former Institute of Medicine ( 2013 ; now the National Academy of Medicine), the Centers for Disease Control and Prevention ( 2013 ), and the World Health Organization ( 2016 ) for whole-of-school

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Monica A.F. Lounsbery and Thomas L. McKenzie

.S. Department of Health and Human Services, 2018 ). Public health entities have also suggested that as much as half of youth’s daily recommended PA should be accrued at school (e.g.,  Institute of Medicine, 2013 ). The Centers for Disease Control and Prevention ( 2019 ) recommends that schools provide “a whole-of-school

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Deborah Salvo, Leandro Garcia, Rodrigo S. Reis, Ivana Stankov, Rahul Goel, Jasper Schipperijn, Pedro C. Hallal, Ding Ding, and Michael Pratt

-being) beyond chronic disease prevention, our scoping review revealed that studies examining the noncardiometabolic and cancer-related health effects of best investments 1 (whole of school approaches), 4 (physical activity promotion in primary care), 5 (mass media campaigns), and 7 (sports-for-all programs

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Tiffany J. Chen, Kathleen B. Watson, Shannon L. Michael, and Susan A. Carlson

, Griffin JL , Slater SJ , O’Malley PM , Johnston LD . The whole-of-school approach to physical activity: findings from a national sample of US secondary students . Am J Prev Med . 2015 ; 49 ( 3 ): 387 – 394 . PubMed ID: 26188684 doi:10.1016/j.amepre.2015.02.012 10.1016/j.amepre.2015.02.012 15