BMC Public Health (Jun 2024)

DE-PASS best evidence statement (BESt): determinants of adolescents’ device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

  • Athanasios Kolovelonis,
  • Ioannis Syrmpas,
  • Anna Marcuzzi,
  • Mohammed Khudair,
  • Kwok Ng,
  • Gavin Daniel Tempest,
  • Ratko Peric,
  • František Bartoš,
  • Maximilian Maier,
  • Mirko Brandes,
  • Angela Carlin,
  • Simone Ciaccioni,
  • Cristina Cortis,
  • Chiara Corvino,
  • Andrea Di Credico,
  • Patrik Drid,
  • Francesca Gallè,
  • Pascal Izzicupo,
  • Henriette Jahre,
  • Atle Kongsvold,
  • Evangelia Kouidi,
  • Paul Jarle Mork,
  • Federico Palumbo,
  • Penny Louise Sheena Rumbold,
  • Petru Sandu,
  • Mette Stavnsbo,
  • Sofia Vilela,
  • Catherine Woods,
  • Kathrin Wunsch,
  • Laura Capranica,
  • Ciaran MacDonncha,
  • Fiona Chun Man Ling,
  • on behalf of DE-PASS

DOI
https://doi.org/10.1186/s12889-024-19136-y
Journal volume & issue
Vol. 24, no. 1
pp. 1 – 26

Abstract

Read online

Abstract Background Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings. Methods A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID: CRD42021282874. Results Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. Conclusions Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables.

Keywords