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Background <p>Swiss adolescents exhibit insufficient physical activity (PA), with most not meeting daily and school-based PA recommendations, and girls being less active than boys. Comprehensive school programs promoting PA across multiple school segments, supported by trained school-based teachers, are considered a promising strategy for sustainably increasing PA. Yet, evidence of their effectiveness—particularly regarding longitudinal, segment-specific changes—remains limited. This study examines the 12-month effectiveness of <i>Active School</i>, a comprehensive PA promotion program allowing schools to autonomously decide which components and goals to implement across different school segments, in Swiss secondary schools, focusing on objectively measured PA across school segments.</p> Methods <p>A quasi-experimental cluster-controlled trial was conducted in 12 self-selected, voluntarily participating secondary schools in the Canton of Bern, Switzerland (six experimental, six wait-list control schools continuing usual practice without PA promotion). In total, 703 students were assessed (mean age 13 years; 49.8% girls). PA in both groups was objectively measured using wrist-worn accelerometers at baseline and after 12 months of mid-term intervention implementation. The primary outcome was moderate-to-vigorous physical activity (MVPA); secondary outcomes were inactivity (IN), light PA (LPA), step counts, and the proportion of students meeting PA-recommendations during school time (≥ 30&#xa0;min MVPA) and across the whole day (≥ 60&#xa0;min MVPA). Outcomes were analyzed across school segments (classtime, recess, physical education), the entire school time, and the whole day. Intervention effects were estimated using linear mixed-effects models.</p> Results <p>No significant intervention effects were observed for MVPA, IN, or LPA across any segments, nor for the proportion of students meeting PA recommendations. However, a significant positive intervention effect emerged for step counts during classtime (adjusted difference in change: 36 steps/hour; 95% CI 15.8 to 56.38, <i>d</i> = 0.29), favoring experimental schools. Exploratory analyses indicated that this effect was driven by girls: those in experimental schools showed a significant increase in their classtime step counts (<i>p</i> &lt; .001, <i>d</i> = 0.56), whereas no change was observed among boys (<i>p</i> = .651, <i>d</i> = 0.06).</p> Conclusions <p>After 12 months, <i>Active School</i> did not improve MVPA or reduce IN, but showed positive effects on step counts during classtime. Given the overall small intervention effects future research should examine implementation fidelity and identify which intervention components may strengthen intervention effectiveness.</p> Trial registration <p>German Clinical Trials Register (DRKS00033362), registered January 25, 2024. Retrospectively registered.</p>

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Effectiveness of the Active School quasi-experimental cluster-controlled trial: Impact on objectively measured physical activity in Swiss secondary school students after 12 months

  • 期刊论文

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  • 发表日期：

    2026年8月5日

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  • Marion Gasser,
  • Andrea-Maria Nadenbousch,
  • Fabienne Egger,
  • Mario Kamer,
  • Stefan Valkanover,
  • Mirko Schmidt

摘要

Background

Swiss adolescents exhibit insufficient physical activity (PA), with most not meeting daily and school-based PA recommendations, and girls being less active than boys. Comprehensive school programs promoting PA across multiple school segments, supported by trained school-based teachers, are considered a promising strategy for sustainably increasing PA. Yet, evidence of their effectiveness—particularly regarding longitudinal, segment-specific changes—remains limited. This study examines the 12-month effectiveness of Active School, a comprehensive PA promotion program allowing schools to autonomously decide which components and goals to implement across different school segments, in Swiss secondary schools, focusing on objectively measured PA across school segments.

Methods

A quasi-experimental cluster-controlled trial was conducted in 12 self-selected, voluntarily participating secondary schools in the Canton of Bern, Switzerland (six experimental, six wait-list control schools continuing usual practice without PA promotion). In total, 703 students were assessed (mean age 13 years; 49.8% girls). PA in both groups was objectively measured using wrist-worn accelerometers at baseline and after 12 months of mid-term intervention implementation. The primary outcome was moderate-to-vigorous physical activity (MVPA); secondary outcomes were inactivity (IN), light PA (LPA), step counts, and the proportion of students meeting PA-recommendations during school time (≥ 30 min MVPA) and across the whole day (≥ 60 min MVPA). Outcomes were analyzed across school segments (classtime, recess, physical education), the entire school time, and the whole day. Intervention effects were estimated using linear mixed-effects models.

Results

No significant intervention effects were observed for MVPA, IN, or LPA across any segments, nor for the proportion of students meeting PA recommendations. However, a significant positive intervention effect emerged for step counts during classtime (adjusted difference in change: 36 steps/hour; 95% CI 15.8 to 56.38, d = 0.29), favoring experimental schools. Exploratory analyses indicated that this effect was driven by girls: those in experimental schools showed a significant increase in their classtime step counts (p < .001, d = 0.56), whereas no change was observed among boys (p = .651, d = 0.06).

Conclusions

After 12 months, Active School did not improve MVPA or reduce IN, but showed positive effects on step counts during classtime. Given the overall small intervention effects future research should examine implementation fidelity and identify which intervention components may strengthen intervention effectiveness.

Trial registration

German Clinical Trials Register (DRKS00033362), registered January 25, 2024. Retrospectively registered.