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Leadership is a valuable skill that can be taught in school, and which may have benefits within and beyond the classroom. Learning to Lead (L2L) is a student-led, primary school-based leadership program whereby older 'peer leaders' deliver a fundamental movement skills (FMS) program to younger 'peers' within their own school. The aims of the study are to determine the efficacy of a peer-led FMS intervention on: (i) peer leaders' (aged 10 to 12 years) leadership effectiveness (primary outcome), leadership self-efficacy, well-being, and time on-task in the classroom; (ii) peers' (aged 8 to 10 years) physical activity levels, actual and perceived FMS competency, cardiorespiratory fitness, muscular power, and executive functioning; and (iii) teachers' (referred to as 'school champions') work-related stress and well-being. L2L will be evaluated using a two-arm parallel group cluster randomised controlled trial. Twenty schools located within a two-hour drive of the University of Newcastle, Australia will be recruited. We will recruit 80 students (40 peer leaders and 40 peers) from each school (N = 1,600). L2L will be implemented in three phases: Phase 1 -school champions' training via a professional learning workshop; Phase 2 -school champions' delivery of leadership lessons to the peer leaders; and Phase 3 -peer leaders' delivery of the FMS program to their younger peers. The FMS program, consisting of 12 x 30-minute lessons, will be delivered over the course of one school term (10 weeks). Study outcomes will be assessed at baseline (between mid-March to June, Terms 1 and 2), intervention end (mid-August to September, Term 3), and follow-up (November to mid-December, Term 4. This trial was prospectively registered on the Australian New Zealand Clinical Trials Registry (ANZCTR); registration number: ACTRN12621000376842.

Background Youth with disability are less physically active and more likely to have chronic health conditions than their peers without disability. The aim of our study was to assess the effectiveness of a scalable school-based physical activity intervention for youth with disability on functional capacity and a range of secondary outcomes. Methods We conducted a two-arm cluster randomized controlled trial involving adolescents aged 15–19 years with diagnosed disabilities ( N  = 255) from 28 secondary schools in New South Wales, Australia. Schools were randomized to the Burn 2 Learn adapted (B2La) intervention, or a wait-list control. The B2La intervention included foundational resistance exercises (e.g., push-ups, bodyweight squats), aerobic exercises (e.g., shuttle runs), and sport skills (e.g., catching, kicking), delivered as classroom activity breaks 2–3 times per week by trained special education teachers. The primary outcome was functional capacity assessed using the 6-min walk or push test. Secondary outcomes were muscular fitness, body mass index, physical activity (accelerometers), resistance training motor competence, motivation for physical activity, high-intensity interval training self-efficacy, quality of life, and externalizing behaviors. Assessments were conducted at baseline, 6-months (primary endpoint), and 9-months (follow-up). Results At 6-months, the intervention group demonstrated a significant improvement in functional capacity, with a group-by-time effect of 20.3 m (95% CI, 3.1–37.1). At 9-months, the effect was 17.8 m (95% CI, 0.0–35.6). The intervention had a small effect on muscular fitness, resistance training motor competence, and high-intensity interval training self-efficacy. No effects were observed for the other outcomes and no adverse events were recorded. Conclusions Physical activity breaks delivered by special education teachers during the school day improved functional capacity and a range of secondary outcomes in youth with disability. Activity breaks may need to be longer, more frequent, or more intense to achieve clinically important health effects. Trial registration Australian New Zealand Clinical Trials Registry Number: ACTRN12621000884808; prospectively registered 15th November, 2021.

The aim of our systematic review and meta-analysis was to quantitatively synthesise the effects of school-based peer-led interventions on leaders’ academic, psychosocial, behavioural, and physical outcomes. Eligible studies were those that: (i) evaluated a school-based peer-led intervention using an experimental or quasi-experimental study design, (ii) included an age-matched control or comparison group, and (iii) evaluated the impact of the intervention on one or more leader outcomes. Medline, Sportdiscus, Psychinfo, Embase, and Scopus online databases were searched on the 24th of October, 2022 which yielded 13,572 results, with 31 included in the narrative synthesis and 12 in the meta-analysis. We found large positive effects for leaders’ attitudes toward bullying (d = 1.02), small-to-medium positive effects for leaders’ literacy (d = 0.39), and small positive effects for leaders’ self-esteem (d = 0.18). There were mixed findings for behavioural outcomes and null effects for physical outcomes. Notable limitations of this research are the inclusion of a relatively small number of studies, and high heterogeneity in those included. Our findings have the potential to inform educational practice, but also highlight the need for further research examining the mechanisms that might account for the observed effects. Our systematic review was prospectively registered with PROSPERO (CRD42021273129).

Background TransformEd is an evidence-based program that targets initial teacher education to equip future teachers with innovative strategies that increase the health, wellbeing and education outcomes of school children. Feasibility, effectiveness and implementation research demonstrate that TransformEd significantly enhances pre-service teachers’ confidence and competence to deliver such strategies. However, to date, the program has only been tested in undergraduate teaching degrees. It is important to gather more evidence for the feasibility and efficacy of the program at all levels of initial teacher education, including at postgraduate level. Methods A feasibility study was conducted to examine the feasibility of embedding TransformEd in a Master of Teaching degree at one Australian university. Preliminary efficacy was measured by pre- and post-program surveys completed by Master of Teaching pre-service teachers who received the 12-week TransformEd program. Implementation was measured by adherence checklists completed by lecturers who delivered TransformEd. Post-program focus groups and interviews with senior academics and lecturers, respectively, explored perceptions of all eight domains of feasibility. Results Survey results demonstrated that the TransformEd program was positively received by pre-service teachers (n = 21), resulting in improvements in several measures of teaching confidence and competence regarding delivering strategies to improve school children’s health, wellbeing and learning. The TransformEd strategies were well adopted by lecturers and implementation increased over time. Both lecturers (n = 3) and senior academics (n = 2) had positive perceptions of the program, highlighting its feasibility in postgraduate initial teacher education. Conclusion This study supports the feasibility and preliminary efficacy of the TransformEd program in postgraduate initial teacher education and provides a foundation for a future controlled trial to rigorously evaluate its impact, with potential population-level benefits for children's health, wellbeing, and educational outcomes in Australia.

IntroductionPhysical activity declines during adolescence, with the lowest levels of activity observed among those with disability. Schools are ideal settings to address this issue; however, few school-based interventions have been specifically designed for older adolescents with disability. Our aim is to investigate the effects of a school-based physical activity programme, involving high-intensity interval training (HIIT), on physical, mental and cognitive health in older adolescents with disability.Methods and analysisWe will evaluate the Burn 2 Learn adapted (B2La) intervention using a two-arm, parallel group, cluster randomised controlled trial with allocation occurring at the school level (treatment or waitlist control). Secondary schools will be recruited in two cohorts from New South Wales, Australia. We will aim to recruit 300 older adolescents (aged 15–19 years) with disability from 30 secondary schools (10 in cohort 1 and 20 in cohort 2). Schools allocated to the intervention group will deliver two HIIT sessions per week during scheduled specialist support classes. The sessions will include foundational aerobic and muscle strengthening exercises tailored to meet student needs. We will provide teachers with training, resources, and support to facilitate the delivery of the B2La programme. Study outcomes will be assessed at baseline, 6 months (primary endpoint), and 9 months. Our primary outcome is functional capacity assessed using the 6 min walk/push test. Secondary outcomes include physical activity, muscular fitness, body composition, cognitive function, quality of life, physical literacy, and on-task behaviour in the classroom. We will also conduct economic and process evaluations to determine cost-effectiveness, programme acceptability, implementation, adaptability, and sustainability in schools.Ethics and disseminationThis study has received approval from the University of Newcastle (H-2021–0262) and the New South Wales Department of Education (SERAP: 2021257) human research ethics committees. Findings will be published in peer-reviewed journals, and key stakeholders will be provided with a detailed report following the study.Trial registration numberAustralian New Zealand Clinical Trials Registry Number: ACTRN12621000884808.

Background Motor competence and executive functions co-develop throughout childhood and adolescence, and there is emerging evidence that improvements in motor competence may have cognitive benefits in these populations. There is a need to provide a quantitative synthesis of the cross-sectional, longitudinal and experimental studies that have examined the association between motor competence and executive functions in school-aged youth. Objectives The primary aim of our systematic review was to synthesise evidence of the association between motor competence and executive functions in school-aged children and adolescents (5–18 years). Our secondary aim was to examine key moderators of this association. Methods We searched the PubMed, PsycINFO, Scopus, Ovid MEDLINE, SPORTDiscus and EMBASE databases from inception up to 27 June 2023. We included cross-sectional, longitudinal and experimental studies that assessed the association between motor competence (e.g., general motor competence, locomotor skills, object control skills and stability skills) and executive functions (e.g., general executive functions, inhibition, working memory and cognitive flexibility) in children and adolescents aged 5–18 years. Results In total, 12,117 records were screened for eligibility, and 44 studies were included. From the 44 included studies, we meta-analysed 37 studies with 251 effect sizes using a structural equation modelling approach in the statistical program R. We found a small positive association (r = 0.18, [95% confidence interval (CI) 0.13–0.22]) between motor competence and executive functions. The positive associations were observed in cross-sectional (r = 0.17, [95% CI 0.13–0.22]), longitudinal ( r  = 0.15, [95% CI 0.03–0.28]) and experimental studies ( r  = 0.25, [95% CI 0.01–0.45]). We also found that general motor competence ( r  = 0.25, [95% CI 0.18–0.33]), locomotor ( r  = 0.15, [95% CI 0.09–0.21]), object control ( r  = 0.14, [95% CI 0.08–0.20]) and stability ( r  = 0.14, [95% CI 0.08–0.20]) skills were associated with executive functions. We did not find any moderating effects for participants’ age on the associations between motor competence and executive functions. Conclusions Our findings suggest a small-to-moderate positive association between motor competence and executive functions in children and adolescents. The small number of experimental studies included in this review support the assertion that interventions targeting children’s motor competence may be a promising strategy to improve their executive functions; however, more research is needed to confirm these findings. Future studies should explore the underlying mechanisms linking motor competence and executive functions as their comprehension may be used to optimise future intervention design and delivery. PROSPERO Registration CRD42021285134.

Background Adolescents with disability are less active and have lower levels of physical fitness than their typically developing peers. Schools are ideal settings to address this; however, few school-based interventions have been designed and evaluated among this group. Therefore, the aim of this pilot study was to determine the feasibility of a time-efficient school-based physical activity intervention for adolescents with disability. Methods A non-randomized pilot trial was conducted with adolescents in the special education unit at one secondary school in New South Wales, Australia. Sixteen grade 11 and 12 students (aged 17.3 ± 0.7 years) participated in the 2-month physical activity intervention. Two classroom teachers were trained to facilitate the delivery of a high-intensity interval training (HIIT) program, known as Burn 2 Learn adapted (B2La). Teachers were asked to deliver 2–3 weekly HIIT sessions for a period of 2 months. Four domains of feasibility (acceptability, implementation, adaptability, and practicality) were assessed using quantitative measures at the student and teacher levels (e.g., observations, process evaluation questionnaires, and heart rate [HR] monitoring). Data were also collected from three learning and support teachers who assisted classroom teachers with intervention delivery. Preliminary efficacy of the intervention on measures of adolescents’ functional capacity (6-min walk/run test) and muscular fitness (sit-to-stand test and modified push-up test) were analyzed using paired sample t-tests. Results Moderate-to-high levels of program satisfaction were reported by both students (80% rated “Good” or “Excellent”) and teachers (100% rated “Good” or “Excellent”). Teachers reported delivering 2.5 ± 0.7 sessions per week during the study. Based on researcher session observations, the program was delivered effectively by teachers (14/20). However, HR data indicated session intensity was lower than intended. The program was considered “adaptable” by teachers, with several observed modifications to HIIT sessions to cater for the needs of adolescents with disability. No adverse events were reported. We observed improvements in preliminary efficacy measures. Conclusions Our findings suggest it is feasible to train teachers to deliver a school-based HIIT program for adolescents with disability. Evaluation of B2La within a larger-scale effectiveness trial is warranted. Trial registration ACTRN12621000219886 .

BackgroundCardiorespiratory fitness (CRF) is an important marker of current and future health status. The primary aim of our study was to evaluate the impact of a time-efficient school-based intervention on older adolescents’ CRF.MethodsTwo-arm cluster randomised controlled trial conducted in two cohorts (February 2018 to February 2019 and February 2019 to February 2020) in New South Wales, Australia. Participants (N=670, 44.6% women, 16.0±0.43 years) from 20 secondary schools: 10 schools (337 participants) were randomised to the Burn 2 Learn (B2L) intervention and 10 schools (333 participants) to the control. Teachers in schools allocated to the B2L intervention were provided with training, resources, and support to facilitate the delivery of high-intensity interval training (HIIT) activity breaks during curriculum time. Teachers and students in the control group continued their usual practice. The primary outcome was CRF (20 m multi-stage fitness test). Secondary outcomes were muscular fitness, physical activity, hair cortisol concentrations, mental health and cognitive function. Outcomes were assessed at baseline, 6 months (primary end-point) and 12 months. Effects were estimated using mixed models accounting for clustering.ResultsWe observed a group-by-time effect for CRF (difference=4.1 laps, 95% CI 1.8 to 6.4) at the primary end-point (6 months), but not at 12 months. At 6 months, group-by-time effects were found for muscular fitness, steps during school hours and cortisol.ConclusionsImplementing HIIT during curricular time improved adolescents’ CRF and several secondary outcomes. Our findings suggest B2L is unlikely to be an effective approach unless teachers embed sessions within the school day.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12618000293268).

Despite well-established benefits, the majority of young people around the globe are not sufficiently active. In many countries, including Australia, physical activity (i.e. physical education and school sport) is not mandatory in the final two years of high school (i.e. senior school years). The aim of this study was to assess the impact of a time-efficient physical activity intervention on senior school students’ on-task behaviour and subjective vitality. This was a sub-study of the Burn 2 Learn (B2L) cluster randomised controlled trial, which included two cohorts. Participants for this sub-study (N = 221) were from 10 secondary schools (23 classes) located in New South Wales, Australia (Cohort 2). Teachers allocated to the B2L intervention group were provided with training, resources and support to facilitate the delivery of two high-intensity activity breaks per week during lesson time for five weeks. A wait-list control was used as comparison group. On-task behaviour was assessed at baseline and post-test, using a momentary time sampling procedure and expressed as a percentage of lesson time. At post-test, subjective vitality was assessed at the start and end of the lesson using a validated questionnaire. Significant group-by-time effects were observed for students’ on-task behaviour in favour of the B2L group [adjusted mean difference = 19.3% of lesson time (95% CI, 0.8 to 37.8), p = 0.042, d = 0.43]. At post-test, significant group-by-time effects were observed for students’ subjective vitality favouring the B2L group [adjusted mean difference = 0.67 units (95% CI, 0.3 to 1.0), p < 0.001, d = 0.36]. The B2L intervention was successful in improving senior school students’ on-task behaviour and their subjective vitality. These findings highlight the potential academic benefits of re-allocating curriculum time to physical activity during the senior school years.

The distribution of time across physical activity, sedentary behaviors, and sleep appears to be essential for the management of obesity. However, the impact of reallocating time among these behaviors, collectively known as 24-h movement behaviors, remains underexplored. This study examines the theoretical effects of reallocating time between 24-h movement behaviors on obesity indicators across different age groups. We performed a pooled data meta-analysis of 9818 participants from 11 observational and experimental studies. To estimate the time spent in movement behaviors, we reprocessed and harmonized individual-level raw accelerometer-derived data. Isotemporal substitution models estimated theoretical changes in body mass index (BMI) and waist circumference (WC) associated with time reallocation between movement behaviors. We performed the analysis separately for children, adolescents, adults, and older adults. Even minor reallocations of 10 min led to significant changes in obesity indicators, with pronounced effects observed when 30 min were reallocated. The most substantial adverse effects on BMI and WC occurred when moderate-to-vigorous physical activity (MVPA) was reallocated to other movement behaviors. For 30-min reallocations, the largest increase in BMI (or BMI z-score for children) occurred when MVPA was reallocated to light-intensity physical activity (LPA) in children (0.26 units, 95% confidence interval [CI] 0.15, 0.37) and to sedentary behavior (SB) in adults (0.72 kg/m , 95% CI 0.47, 0.96) and older adults (0.73 kg/m , 95% CI 0.59, 0.87). The largest increase in WC was observed when MVPA was substituted with LPA in adults (2.66 cm, 95% CI 1.42, 3.90) and with SB in older adults (2.43 cm, 95% CI 2.07, 2.79). Conversely, the highest magnitude of the decrease in obesity indicators was observed when SB was substituted with MVPA. Specifically, substituting 30 min of SB with MVPA was associated with a decrease in BMI z-score by - 0.15 units (95% CI - 0.21, - 0.10) in children and lower BMI by - 0.56 kg/m (95% CI - 0.74, - 0.39) in adults and by - 0.52 kg/m (95% CI - 0.61, - 0.43) in older adults. Reallocating time away from sleep and LPA showed several significant changes but lacked a consistent pattern. While the predicted changes in obesity indicators were generally consistent across age groups, inconsistent findings were observed in adolescents, particularly for reallocations between MVPA and other behaviors. This investigation emphasizes the crucial role of MVPA in mitigating obesity risk across the lifespan, and the benefit of substituting SB with low-intensity movement behaviors. The distinct patterns observed in adolescents suggest a need for age-specific lifestyle interventions to effectively address obesity. Emphasizing manageable shifts, such as 10-min reallocations, could have significant public health implications, promoting sustainable lifestyle changes that accommodate individuals with diverse needs, including those with severe obesity.