Table 1 Characteristics of included studies
From: Health effects of children’s summer holiday programs: a systematic review and meta-analysis
First author (year) country | Study design | Participants Sample size n= (%female) Mean age years (SD) | Intervention: Goal, description and dose | Construct and outcome measure | Time-points measured |
|---|---|---|---|---|---|
D’Haese (2015) Belgium [53] | Non-RCT | 6–12 year-old primary school children living close to a “Play Street” n = 167 (45%F) Mean age: 9 (2.1) | Goal: Increase moderate-to vigorous-intensity PA and decreased SB Description: “Play Streets” organised by volunteers, supervised by parents; provided with a box of play equipment and safe play space. Dose: Day program, (5 h/day): 7–14 day duration (7 sessions total) | PA: (MVPA min/day) SB: (min/day) Actigraph accelerometer (hip-worn) | Baseline: “half a week” during a normal week prior to intervention. Mid-intervention: “half a week” during the play-street |
Dugger (2020) USA [51] | Non-RCT | 2nd -4th grade low-SES primary school students n = 180 (60%F) Mean age: 7.9 | Goal: Reduce summer decline in reading achievement and mitigate accelerated unhealthy BMI gain Description: Healthy School Learners program led by certified teachers with periods of PA, reading, and nutrition sessions; participants received meals Dose: Day program (7.5 h/day): 4 days/w, 6w duration (24 sessions total) | PA: MVPA (min/day, total steps/day) SB: (min/day), Sleep (total min, onset, offset); Fitbit charge 2TM Diet: (quality): healthy & unhealthy food/drinks; Parent Report Food Screener Screen time: (min/day, min > 8pm); parent proxy report | Continuous measures (12 weeks) for PA, sleep. Weekly measures of screen use and diet (2x per week inc. weekdays and weekend days). |
Evans (2018) USA [48] | Non-RCT | 6–12 year-old children from diverse low-income backgrounds n = 81 (%F NR) Mean age: NR | Goal: Prevent summertime weight-gain Description: Promoting Health and Activity in Summer Trial included minimum 2 h PA and lunch run by college age staff Dose: Day program (4 h/day): 5 days/w, 8w duration (39 sessions total) | PA: (MVPA, min/day), SB: (min/day, %time); Actigraph Accelerometer (hip worn) Diet: (energy intake); 24-hr diet recalls Adiposity: (BMIz); height and weight calculation | Baseline (end of the school year): BMIz. Mid-intervention (weeks 4 & 5): PA & diet: Post-intervention (last week of summer): BMIz |
Evans (2020) USA [33] | RCT | 6–12 year-old children from racially diverse, low-income communities with high overweight/obesity prevalence n = 96 (58.3%F) Mean age: NR | Goal: Prevent excess summer weight gain by increasing PA, decreasing SB, and improving diet. Description: Curriculum included sports, games, obstacle courses, swimming and boating, arts and crafts with breakfast and lunch Dose: Day program (7.5 h/day): 7-8w duration (34–39 sessions total) | PA: (MVPA, min/day, %time), SB: (%time), Actigraph Accelerometer (wrist worn) Diet (energy intake, dietary quality); Healthy Eating Index Adiposity (BMIz) | Baseline (end of the school year): BMIz, PA, diet. Mid-intervention (weeks 4 & 5): PA & diet: Post intervention (last week of summer): BMIz |
Gately (2005) UK [49] | Non-RCT | 9–18 year-old children with overweight or obesity n = 357 (%F NR) Mean age: NR | Goal: Provide a safe supportive environment where children could reduce body mass whilst having fun Description: Structured PA, focussing on fun and skills led by PE teachers; moderate dietary restriction, and 4 educational sessions Dose: Residential program (6 h/day) 2-6w | Adiposity (BMIz, %body fat); Air displacement plethysmography Fitness (CRF); submaximal treadmill walking protocol | All measures taken at baseline (“start of the program”) and post-intervention (“end of the program”) |
Hazar (2019) Turkey [52] | Non-RCT | 7–12 year-old healthy children who enrolled in summer sports schools n = 132 (50%F) Mean age: 8.7 (SD NR) | Goal: Increase exercise to improve fitness and body weight of children Description: 2 h aerobic exercises in the educational play format run by sports trainers Dose: Day program (2 h/day): 5 days/w, 8w duration (40 sessions total) | Body size: Height, body weight Fitness (muscular); standing long jump, shot put, sit-ups, 20-m sprint) | All measures taken at baseline and post-intervention (8 weeks apart). |
Matsui (2019) Japan [50] | Non-RCT | 4th grade students from public elementary schools n = 67 (54%F) Mean age: NR | Goal: Maintain/PA in school aged children over summer holidays Description: Physical education homework for the summer vacation made up of 4 exercise programs per day with 4 exercise events Dose: Home-based and day program (30–90 min/day): 42 days duration | PA: (MVPA & LPA mins/day, steps/day), Lifecorder EX Accelerometer (waist-worn) | Measures taken at baseline (five weekdays in final week of school) & mid-intervention (14 days during summer). |
Meucci (2013) USA [47] | RCT | 8–12 year-old adolescents not attending structured or supervised sport activities out of school n = 22 (45%F) Mean age: 9.9 (1.2) | Goal: Have adolescents learn lifetime sport and recreational activities while increasing the time spent in exercise Description: Intermittent PA with play-based format plus nutrition classes; healthy snacks and lunches provided Dose: Day program (6 h/day): 5 days/w, 4-8w duration | Adiposity (BMI, %body fat); Foot-to-foot bioelectrical impedance analyser Anthropometrics (trunk & leg peak height velocity) Metabolic function (resting energy expenditure, resting heart rate); Polar Wear Link and transmitter Fitness (CRF: peak aerobic capacity); direct gas analysis during modified protocol treadmill test | All measures taken at baseline (4 days pre-program) and post-intervention (within 48 h of the end of the intervention) |
Park (2015) USA [44] | Non-RCT | 15–17 year-old under-privileged high school students n = 145 (%F NR) Mean age: NR | Goal: Increase PA and reduce dietary intake to improve body composition and physical fitness Description: Aerobic exercises, resistive exercises with body weight, and a variety of games; provided with breakfast and lunch Dose: Day program (8 h/day): 5 days/w, 5w duration (25 sessions total) | Body size (height, weight) Adiposity (% body fat); skin fold calliper Fitness (CRF) VO2 max; Queens College step test, (MF); push-up test (Flexibility); sit-and-reach test | All measures taken at baseline (last two weeks of school year, May) and post-intervention (first two weeks of new school year, August) |
von Klingraeff (2022) USA [34] | Non-RCT | 2nd -4th grade low-SES primary school students between the 25th and 75th percentile on measures of academic progress n = 199 (%F NR) Mean age: NR | Goal: Prevent accelerated BMI gain and academic learning loss over the summer holidays Description: Healthy School Learners program led by certified teachers with periods of PA, reading, and nutrition sessions run by teachers; participants received meals Dose: Day program (7.5 h/day): 4 days/w, 6w duration (24 sessions total) | Adiposity (BMIz) Fitness (CRF); PACER laps | All measures taken at baseline (last month of the school year), post-intervention (3 months from baseline) and follow-up (12 months from baseline) |