Abstract:

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.

Key words: health promoting-school, physical activity, school health service, systematic review