School-based environment and physical activity in adolescents: A systematic review and meta-analysis.

Objective: This study aimed to evaluate the effectiveness of school environmental factors in promoting adolescents' physical activity.

Methods: A systematic search of five databases (PubMed, Embase, Web of Science, EBSCO, and Cochrane Library) was conducted from the earliest available records up to September 2023. Meta-analyses were performed for each school environmental factor, provided that at least two studies reported on the association between that factor and adolescents' physical activity. The factors examined included seven school social environmental factors and six school physical environmental factors.

Results: 18 studies comprising 340,749 participants were included in the meta-analysis. A significant positive correlation was observed between the school environment and adolescents' physical activity. Specifically, the school social environment was positively associated with adolescents' physical activity. In particular, school-offered daily physical education, school-organized extracurricular physical activities, encouragement of using sports equipment or facilities, and outdoor obstacle course were all significantly positively correlated with adolescents' physical activity. While the overall school physical environment did not show a significant relationship with adolescents' physical activity, the number of school physical activity facilities demonstrated a significant positive correlation with adolescents' physical activity.

Conclusions: This meta-analysis demonstrates the role of school environment in promoting adolescents' physical activity. School social environmental factors, including school-offered daily physical education, school-organized extracurricular physical activities, encouragement to use sports resources, and outdoor obstacle courses, are particularly effective in enhancing adolescents' physical activity. Among school physical environmental factors, the number of physical activity facilities was found to be a key factor in promoting adolescents' physical activity.