基于WHO-HPS架构学校身体活动相关健康服务及其健康效益:系统综述的系统综述

School-based physical activity-related health services and their health benefits within the World Health Organization health-promoting school framework:a systematic review of systematic reviews

目的 系统综述世界卫生组织健康促进学校(WHO-HPS)架构下学校课程体系、身体活动相关健康服务类型及其对儿童青少年健康的影响。方法 检索EBSCO、PubMed、Web of Science和中国知网2017年至2023年6月公开发表的有关基于WHO-HPS架构的学校身体活动相关服务及其健康效益的系统综述,并进行系统综述。结果 最终纳入7篇英文系统综述,涉及147项研究,来自5个国家,包括瑞士、美国、意大利、英国和瑞典,主要来源于儿童体育与健康、HPS、学校身体活动等领域期刊,发表时间主要集中在2017年至2022年。基于WHO-HPS架构,学校实施的健康促进类课程体系主要涉及体育课(增加专门的运动项目课程如瑜伽、舞蹈,增加身体活动时间)和身体活动相关的健康教育课程、课外活动(包括实施儿童体育、娱乐和休闲计划、午餐享受活动和游戏计划,在学校常规课程中增加身体活动时间,创造课间休息和放学后额外的身体活动机会,提供日常身体活动计划)以及融入身体活动的其他课程。身体活动相关健康服务主要包括身体活动相关的健康筛查和监测、身体活动相关的青少年健康管理和健康促进活动。这些干预措施带来的健康效益主要包括改善有氧能力、体质量指数、心肺功能及整体身体健康状况,以及显著提高肌肉耐力和肌肉力量;中止或减少久坐行为,提高全天身体活动和中高强度身体活动的水平,提高身体活动参与水平,在学生课程时间中显著增加身体活动,提高在校期间进行中高强度身体活动的比例,增加身体活动时间;有效提升身体活动相关的娱乐/休闲时间,提高活力、在校生活质量和精力,提升学业成绩,减少看电视时间,降低肥胖风险,减少焦虑,提高适应力和幸福感,促进积极心理健康;显著提高学生身体活动相关的健康知识。结论 在学校实施HPS课程和身体活动相关服务,可以改善学生健康的各个方面,包括身体健康、身体活动和久坐行为、与身体活动相关的行为健康以及与身体活动相关的健康素养。

Objective To systematically review the types of health-promoting school(HPS) curriculum and physical activity-related health services based on the WHO-HPS framework,and their impact on health of children and adolescents.Methods The databases of EBSCO,PubMed,Web of Science,and CNKI were searched on school-based physical activity-related services and their health benefits based on the WHO-HPS framework from 2017 to June,2023.A systematic review of systematic reviews was conducted.Results A total of seven English articles were included,covering 147 studies from five countries including Switzerland,the United States,Italy,the United Kingdom and Sweden.The systematic reviews were published in the journals related to child physical education and health,HPS,and school-based physical activity.Based on the WHO-HPS framework,HPS curriculum implemented in schools primarily involved physical education classes(such as incorporating specialized sports programs like yoga and dance,increasing physical activity time) and health education programs related to physical activity.Additional activities included extracurricular programs(such as implementing children's sports,recreational and leisure programs,lunchtime enjoyment activities,and game plans,increasing physical activity time within regular school hours,creating opportunities for physical activity during breaks and after school,and providing daily physical activity plans) and integration of physical activity in other subjects.Physical activity-related health services mainly included health screening and monitoring related to physical activity,adolescent health management,and health promotion activities.The health benefits of the interventions included improvement in aerobic capacity,body mass index,cardiorespiratory function,overall physical health,and significant increases in muscle endurance and strength.They also contributed to the cessation or reduction of prolonged sedentary behavior,increased levels of all-day physical activity and moderate-to-vigorous physical activity,increased physical activity participation,significant increases in physical activity during school hours,increased proportion of moderate to vigorous physical activity during school time,increased physical activity time,improved leisure and recreational time related to physical activity,enhanced vitality,school quality of life,and energy,improved academic performance,reduced television viewing time,decreased obesity risk,reduced anxiety,improved adaptability and happiness,and promoted positive mental health.Furthermore,there was a significant improvement in students' health-related knowledge on physical activity.Conclusion Implementing HPS curriculum and physical activity-related services in schools may improve various aspects of students' health,including physical fitness,physical activity and sedentary behavior,behavioral health related to physical activity,and health literacy related to physical activity.