Based on the inclusion criteria determined for the identification of studies for the systematic review, only three studies conducted in German language countries were identified (Graf et al., 2008; Graf et al., 2005; Haas, Väth, Bappert, & Bös, 2009; Walther et al., 2009).
Nevertheless, it is known that in German language countries several further research projects exist in this field. Therefore, a second more differentiated search was carried out based on conference papers, the homepages of the sport institutes in Germany, and the main German scientific journals “Sportwissenschaft” and “Sportunterricht”. This search revealed another 13 German projects corresponding to the inclusion criteria – with exceptions concerning two criteria – also set for the main systematic review described in the previous section. These exceptions were that the studies had to be conducted in German language countries and the publication type was not restricted to journal articles but was much more widened and thus, studies reported in books, dissertations or mainly presented in the internet were also considered. This was necessary because the publication tradition especially in the field of sport pedagogy differs compared to other disciplines with a longer tradition in empirical research. Usually the projects carried out in sport pedagogy in Germany are not reported in journal articles but rather are published in the form of reports in books or dissertations. Thus, it is important to also consider these publication types in order to present a complete picture of the research development in this field in German language countries.
Based on this research further 13 projects carried out in German language countries were retrieved. All of these projects aimed to positively influence the health of primary and high school students in the school setting. To achieve this aim, a variety of programmes were designed and implemented. Several intervention studies designed a programme which was carried out during the already existing PE hours aiming to influence a specific aspect relevant
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74 to students’ health such as physical activity levels, physical fitness levels or healthy eating (Dreyhaupt et al., 2012; Günther, 2004a, 2004b; Reuter & Buskies, 2003; Steinmann, 2004).
Three studies were identified that analysed the effects of daily PE on a variety of outcome variables (Bös & Obst, 2007; Henze, 2007; Thiele & Seyda, 2011) and three further programmes incorporated several aspects to be carried out during the school day (Landau, 2007; Müller & Petzold, 2002; Nellen-Swiathly & Schindler-Marlow, 2006). Finally, one programme provided the opportunity to go to school on foot accompanied by adults (Brettschneider & Malek, 2006). Most of these programmes were successful in achieving a positive influence of students’ health measured by outcome variables such as motor performance, BMI, physical activity and academic performance. Some examples of these German projects are described in the following in more detail and all 12 projects are summarised in table 10.
Steinmann (2004) carried out an innovative programme in the school setting in order to examine the effects of PE on students’ fitness status, athletic performance, and attitudes towards the health effects of physical activity. To achieve this aim he used a quasi-experimental design and analysed six fifth grade classes in German high schools. The participating classes were divided into two IGs and one CG. Both IGs carried out a practical PE programme and the second IG was additionally taught some theoretical lessons during biology classes concerning the association between physical activity and health. During the five-week intervention timeframe the CG carried out the regular PE lessons. The results gained from this empirical study are promising and show mostly positive intervention effects especially in favour of the IG carrying out the practical and the theoretical components.
Concerning motor performance, positive intervention effects on students of both IGs were observed in standing long jump, sit-ups, 6-min run, and 30m sprint. In the test measuring the maximum strength of the arms and the reaction speed no significant differences between the IGs and the CG could be observed. Positive intervention effects were measured in favour of the IG carrying out the practical and the theoretical elements in the cognitive and affective dimensions of the questionnaire assessing students’ attitudes towards the health effects of PE.
Finally, significant positive intervention effects were also found in athletic performance in the disciplines long jump and 50m sprint but not in the heavy ball throw.
A second empirical study carried out in this field is the largest school-based health promotion programme carried out in Germany by a workgroup in the federal state Baden-Württemberg (Dreyhaupt et al., 2012). This school-based programme aimed to promote a healthier lifestyle in primary aged school children. In more detail, the main goals of the programme were to increase children’s physical activity levels, to decrease the consumption of sugar-sweetened drinks, and to decrease the time spent sedentary by promoting active choices. Also, it was aimed to increase students’ mental and emotional abilities. This cluster-randomised study included 427 primary schools and measurements were taken in the years 2010/2011 and 2011/2012. The interventions effectiveness was assessed on three main outcome variables:
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75 changes in waist circumference, skinfold thickness, and 6-min run. The intervention programme was fully integrated in the school environment during the existing school hours and in recess. Particularly motivated teachers were trained as project delivery consultants that were assigned to train about 900 primary school teachers to be able to teach a series of specific health-promotion lessons as part of their routine work. Along with the outcome measures also process measures were assessed to examine the quality of the programme. The intervention programme was designed by a team of scientists in collaboration with primary school teachers based on the salutogenetic and social cognitive theory. Additionally, the programme was oriented towards an action approach. The intervention included 20 units per school year and was carried out from the first to fourth grade in primary school. These 20 lessons were spread over the entire academic year with the exception of two physical activity exercises that were carried out daily. These were the active recess and five to seven minutes of daily exercises. Additionally, “family homework” was assigned to the students that included exercises that should be carried out with the parents. Unfortunately, the results of the programme are not available yet. Nevertheless, this project will soon provide high evidence based results on whether it is possible to achieve health effects in students based on a programme involving children, teachers, and parents with relatively little effort.
A third project that was carried out in Germany aimed to examine the health effects of daily PE on socio-psychological factors as well as motor performance (Thiele & Seyda, 2011).
Altogether 27 schools participated in this quasi-experimental project. Of these schools, 25 carried out a daily PE class but only eight schools were evaluated in detail by the research team. Two schools carried out the regular PE lessons and were set as the CG schools. It was assumed that the daily PE lessons would cause changes on several levels. First, the intervention effects were examined directly on students’ self-concept and their coordination levels. Additionally, the teachers were questioned on the possible effects of daily PE on students and the changes in PE itself. Also organisational changes and staff development were analysed. For this purposes qualitative as well as quantitative procedures for the data assessment were used. Teachers and students were asked what expectations they had concerning the daily PE. Both adults and youngsters responded to this question in a similar way. They assumed that daily PE would have positive effects on students’ motor performance, on the overall learning ability and concentration, their cooperation with other students, decrease aggression levels, and an overall positive effect on their personality development. Nevertheless, these positive expectations could not be confirmed in the statistical analysis of the data gained from the questionnaires filled out by the students. Here, no positive intervention effects were found on students’ self-concept and their motor performance. At this point it needs to be emphasised that the results gained from the other two studies (Bös & Obst, 2007; Henze, 2007) analysing the effects of daily PE were not able to confirm positive intervention effects on students motor performance, BMI, and social behaviour.
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76 Concluding, it can be said that when taking into account the great importance of the school setting for the promotion of students’ health and the fact that health promotion should be one of the central targets of PE, it is striking that up to now only few intervention studies have been carried out in this field in Germany. These programmes seem to be especially effective in improving students’ physical fitness levels since nine of the ten studies examining this variable led to significant intervention effects in favour of the IG. Interestingly though, the large study by Thiele and Seyda (2011) examining the effects of daily PE could not confirm this hypothesis. This is an indication that the mere increase in PE hours is not sufficient to provide improvements in students’ physical fitness levels. Instead, a programme needs to specifically address students’ physical fitness in order to achieve positive results. In general, it is especially important to examine the health effects that can be achieved through PE when taking into account the specific circumstances in which PE is currently being carried out in Germany. Therefore, more research is needed that can determine the health effects that can be achieved when PE is only carried out two or three times per week as it is currently manifested in the PE curriculum. Only in this way conclusions can be drawn concerning the extent to which PE can contribute to young people’s health.
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77 Table 10 School-Based Physical Activity Intervention Studies in German Language Countries
Author/ Project Aim Study design Assessed variables Intervention programme Results Bös & Obst (2007)
Daily PE o Positive intervention effects in the motor performance in the two out of three weekly PE hours available.
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78 Author/ Project Aim Study design Assessed variables Intervention programme Results
of social acceptance
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79 Author/ Project Aim Study design Assessed variables Intervention programme Results
Henze (2007)
o Education on the function of the spine und a healthy
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80 Author/ Project Aim Study design Assessed variables Intervention programme Results
BMI, strength, and
During two out of the three PE hours provided, a specific intervention programme to
o Positive intervention effects on motor performance and athletic performance in both
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81 Author/ Project Aim Study design Assessed variables Intervention programme Results
(Gesundheit,
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82 3.4 Chapter summary
For the design of effective intervention programmes to promote young people’s health in the school setting, it is a premise to gain an overview over the current state of the empirical research findings in this field. It is essential to know what kind of intervention programmes were carried out in the past years and it is also substantial to know which interventions were effective and which were not. Therefore, also for this research project it was essential to systematically view the empirical studies that were carried out in the past years before designing HealthyPEP (see chapter 4).
Consequently, in this chapter, in a first step (see section 3.2), the international literature was systematically reviewed and analysed in a systematic review that presented the current status concerning physical activity in school-based intervention programmes carried out internationally (Demetriou & Höner, 2012). The systematic review included 129 intervention studies that fulfilled the predefined inclusion criteria. Most of these studies were of moderate methodological quality according to the chosen criteria in this systematic review. The analysis of the effects of the studies on the three target levels (psychological determinants of physical activity, physical activity behaviour, and health and fitness) revealed that these programmes especially achieved positive effects on students’ knowledge (87.5%), motor performance (69.7%), and physical activity levels (56.8%). Additionally, it was found that participants’
age, the type of intervention (only a physical activity component vs. a combination of a physical activity and a cognitive component), frequency and duration of the intervention studies, and methodological quality had a moderating effect on the intervention effects.
Finally, also in this systematic review it was confirmed that only very few studies could accomplish the difficult task of examining the mediator effects of psychological determinants of physical activity.
In a second step, additional interventions carried out in German language countries that were not included into the systematic review were presented (see section 3.3). These interventions did not fulfil the inclusion criteria for the systematic review but are equally important in order to present a complete picture of the current status of the empirical research in this field.
Altogether another 13 studies were presented that were especially effective in improving students’ physical fitness levels. Based on these studies it becomes clear that specific programmes need to be developed to enhance students’ fitness and that a mere increase in PE is insufficient.
It can be concluded that more research is needed in this field in order to determine the health effects that can be achieved in PE. Especially in Germany, studies are needed that examine the effects of two or three PE hours per week as it is currently laid down in the PE curriculum.
Only in this way conclusions can be drawn concerning the extent to which PE can contribute to young people’s health.
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83 4 Intervention Study: Development and Evaluation of HealthyPEP
Based on the recent theoretical and empirical findings (see chapters 2 and 3), in the following chapter the intervention study of this research project is described. After stating the objectives of this study (see section 4.1), first, the development of HealthyPEP2 (see section 4.2), and second, the comprehensive evaluation of HealthyPEP (see section 4.3) based on Mittag (2006) is presented.