Active transportation to school over 2 years in relation to weight status and physical activity. The Walking School Bus and Children's Physical Activity: A Pilot Cluster Randomized Controlled Trial Cognitively challenging physical activity benefits executive function in overweight children An alternative design for small-scale school health experiments: does daily walking produce benefits in physical performance of school children? The mode of school transportation in pre-pubertal children does not influence the accrual of bone mineral or the gain in bone size - two year prospective data from the paediatric osteoporosis preventive (POP) study Intervention Effects of a School-Based Health Promotion Programme on Obesity Related Behavioural Outcomes Influence of a lifestyle intervention in preschool children on physiological and psychological parameters (Ballabeina): study design of a cluster randomized controlled trial Cross sectional analysis of the association between mode of school transportation and physical fitness in children and adolescents Do school-based physical activity interventions increase or reduce inequalities in health? Clustered randomised controlled trial of two education interventions designed to increase physical activity and well-being of secondary school students: the MOVE Project Longitudinal Changes in Active Transportation to School in Canadian Youth Aged 6 Through 16 Years Effects of a Randomised Controlled School-Based Health Promotion Intervention on Obesity Related Behavioural Outcomes of Children with Migration Background A controlled trial of health promotion programs in 11-year-olds using physical activity "enrichment" for higher risk children. Bone mineral accrual and gain in skeletal width in pre-pubertal school children is independent of the mode of school transportation – one-year data from the prospective observational pediatric osteoporosis prevention (POP) study Improved functional ability and independence in activities of daily living for older adults at high risk of hospital readmission: a randomized controlled trial. Behavioural and weight status outcomes from an exploratory trial of the Healthy Lifestyles Programme (HeLP): a novel school-based obesity prevention programme Promoting active transport in a workplace setting: evaluation of a pilot study in Australia.
OBJECTIVE To prospect ively examine potential benefits of active commuting to school on measures of weight status and physical activity in a sample of youth . RESEARCH METHODS AND PROCEDURES A cohort of students from seven elementary schools was measured four times -- in the fall and spring of fourth grade ( N = 1083 ) and fifth grade ( N = 924 ) . Participants were classified as active ( walking , biking , or skateboarding to school almost every day for baseline analyses or at least 2 d/wk for analyses of consistent active commuting ) or non-active commuters to school . Accelerometers were used to measure physical activity . Height , weight , and skinfolds were objective ly assessed . RESULTS Boys who actively commuted to school had lower BMI ( p < 0.01 ) and skinfolds ( p < 0.05 ) than non-active commuters to school in the fourth grade . Active commuting to school over 2 years was not associated with BMI change or overweight status . DISCUSSION Walking and cycling to school may contribute to preventing excessive weight gain , or leaner children may walk or cycle to school OBJECTIVE : To evaluate the impact of a “ walking school bus ” program on  children 's rates of active commuting to school and physical activity . METHODS : We conducted a pilot cluster r and omized controlled trial among 4th- grade rs from 8 schools in Houston , Texas ( N = 149 ) . R and om allocation to treatment or control conditions was at the school level . Study staff walked with children to and from school up to 5 days/week . Outcomes were measured the week before ( time 1 ) and during weeks 4 and 5 of the intervention ( time 2 ) . The main outcome was the weekly rate of active commuting , and a secondary outcome was moderate-to-vigorous physical activity . Covariates included sociodemographics , distance from home to school , neighborhood safety , child BMI z score , parent self-efficacy/ outcome expectations , and child self-efficacy for active commuting . A mixed-model repeated measures regression accounted for clustering by school , and stepwise procedures with backward elimination of nonsignificant covariates were used to identify significant predictors . RESULTS : Intervention children increased active commuting ( mean ± SD ) from 23.8 % ± 9.2 % ( time 1 ) to 54 % ± 9.2 % ( time 2 ) , whereas control subjects decreased from 40.2 % ± 8.9 % ( time 1 ) to 32.6 % ± 8.9 % ( time 2 ) ( P < .0001 ) . Intervention children increased their minutes of daily moderate-to-vigorous physical activity from 46.6 ± 4.5 ( time 1 ) to 48.8 ± 4.5 ( time 2 ) , whereas control children decreased from 46.1 ± 4.3 ( time 1 ) to 41.3 ± 4.3 ( time 2 ) ( P = .029 ) . CONCLUSIONS : The program improved children 's active commuting to school and daily moderate-to-vigorous physical activity Abstract This study tested the association between aerobic fitness and executive function and the impact of enhanced , cognitively challenging physical activity on executive function in overweight and lean children . Seventy children aged 9–10 years were assigned to either a 6-month enhanced physical education programme including cognitively dem and ing ( open skill ) activities or curricular physical education only . Pre- and post-intervention tests assessed aerobic capacity ( Leger test ) and two components of executive function : inhibition and working memory updating ( r and om number generation task ) . Indices of inhibition and memory updating were compared in higher- and lower-fit children and intervention effects were evaluated as a function of physical activity programme ( enhanced vs. curricular ) and weight status ( lean vs. overweight ) . Results showed better inhibition in higher- than lower-fit children , extending the existing evidence of the association between aerobic fitness and executive function to new aspects of children ’s inhibitory ability . Overweight children had more pronounced pre- to post-intervention improvements in inhibition than lean children only if involved in enhanced physical education . Such intervention effects were not mediated by aerobic fitness gains . Therefore , the cognitive and social interaction challenges inherent in open skill tasks , even though embedded in a low-dose physical activity programme , may represent an effective means to promote cognitive efficiency , especially in overweight children BACKGROUND The mainstream r and omized clinical trial is not always feasible in a school setting . There might be practical and ethical issues that make dividing school classes into an intervention and a control group impossible or undesirable , and there is a need to explore the validity of alternative design s and analyses . METHODS An alternative to a r and omized clinical trial in a physical performance experiment at a school is introduced and evaluated . The before-intervention data are utilized as control data for the intervention data in addition to adjust for pre-intervention differences . The strict class year structure of school data makes this possible . In a rural school in inl and Norway , all school children joined the project of walking in a rugged terrain outside school for 20 min every school day during one school year . Measurements of low back static endurance , hamstrings flexibility , st and ing balance and cardiovascular fitness were made before and after the intervention . As intervention and ' aging ' were confounded , the special use of the pre-intervention data , ' age-adjusted ' , is proposed to solve this issue . A comparison with having an independent control group is performed . RESULTS The alternative analysing method is judged to yield valid results without having an independent control group . The age-adjusted analyses showed 11 % increase in low back static endurance , 8 % increase in hamstrings flexibility , 69 % increase in balance and 6 - 13 % increase in cardiovascular fitness . The effects were largest among those children who had the lowest performances before the intervention . CONCLUSION The introduced statistical methods display that , in a school population , evaluations from an experiment can be made without an independent control group . A 20-min walk during school time for 1 year seemed to improve physical performance Background Walking and cycling to school are one source of regular physical activity . The aim of this two years observational study in pre-pubertal children was to evaluate if walking and cycling to school was associated with higher total amount of physical activity and larger gain in bone mineral content ( BMC ) and bone width than when going by car or bus . Methods 133 boys and 99 girls aged 7 - 9 years were recruited to the Malmö Prospect i ve Paediatric Osteoporosis Prevention ( POP ) study .  BMC ( g ) was measured by dual X-ray absorptiometry ( DXA ) in total body , lumbar spine ( L2-L4 ) and femoral neck ( FN ) at baseline and after 24 months . Bone width was measured in L2-L4 and FN . Skeletal changes in the 57 boys and 48 girls who consistently walked or cycled to school were compared with the 24 boys and 17 girls who consistently went by bus or car . All children remained in Tanner stage I. Level of everyday physical activity was estimated by accelerometers worn for four consecutive days and question naires . Comparisons were made by independent student 's t-tests between means and Fisher 's exact tests . Analysis of covariance ( ANCOVA ) was used to adjust for group differences in age at baseline , duration of organized physical activity , annual changes in length and BMC or bone width if there were differences in these traits at baseline . Results After the adjustments , there were no differences in the annual changes in BMC or bone width when comparing girls or boys who walked or cycled to school with those who went by car or bus . Furthermore , there were no differences in the levels of everyday physical activity objective ly measured by accelerometers and all children reached above the by the United Kingdom Expert Consensus Group recommended level of 60 minutes moderate to vigorous physical activity per day . Conclusion A physical active transportation to school for two years is in pre-pubertal children not associated with a higher accrual of BMC or bone width than a passive mode of transportation , possibly due to the fact that the everyday physical activity in these pre-pubertal children , independent of the mode of school transportation , was high Studies have shown preventive effects of an active lifestyle during childhood on later life ; therefore , health promotion has to start early . The programme “ Join the Healthy Boat ” promotes a healthy lifestyle in primary school children . In order to evaluate it , children 's behaviours in respect of  increased physical activity ( PA )  , a decrease in screen media use ( SMU ) , more regular breakfast , and a reduction of the consumption of soft drinks ( SDC )  were investigated . 1943 children ( 7.1 ± 0.6 years ) participated in the cluster-r and omised study and were assessed at baseline and 1736 of them at follow-up . Teachers delivered lessons , which included behavioural contracting and budgeting of SMU and SDC . Daily SMU , PA behaviours , SDC , and breakfast patterns  were assessed via parental question naire . After one-year intervention , significant effects were found in the intervention group for SMU of girls , children without migration background , and children with parents having a low education level . In the control group , second grade children  skipped breakfast significantly more often . Tendencies but no significant differences were found for PA and SDC . This intervention seems to affect groups , which are usually hard to reach , such as children of parents with low education levels , which shows that active parental involvement is vital for successful interventions Background Childhood obesity and physical inactivity are increasing dramatically worldwide . Children of low socioeconomic status and /or children of migrant background are especially at risk . In general , the overall effectiveness of school-based programs on health-related outcomes has been disappointing . A special gap exists for younger children and in high risk groups . Methods / Design This paper describes the rationale , design , curriculum , and evaluation of a multicenter preschool r and omized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons . Twenty preschool classes in the German ( canton St. Gallen ) and another 20 in the French ( canton Vaud ) part of Switzerl and were separately selected and r and omized to an intervention and a control arm by the use of opaque envelopes . The multidisciplinary lifestyle intervention aim ed to increase physical activity and sleep duration , to reinforce healthy nutrition and eating behaviour , and to reduce media use . According to the ecological model , it included children , their parents and the teachers . The regular teachers performed the majority of the intervention and were supported by a local health promoter . The intervention included physical activity lessons , adaptation of the built infrastructure ; promotion of regional extracurricular physical activity ; playful lessons about nutrition , media use and sleep , funny homework cards and information material s for teachers and parents . It lasted one school year . Baseline and post-intervention evaluations were performed in both arms . Primary outcome measures included BMI and aerobic fitness ( 20 m shuttle run test ) . Secondary outcomes included total ( skinfolds , bioelectrical impedance ) and central ( waist circumference ) body fat , motor abilities ( obstacle course , static and dynamic balance ) , physical activity and sleep duration ( accelerometry and question naires ) , nutritional behaviour and food intake , media use , quality of life and signs of hyperactivity ( question naires ) , attention and spatial working memory ability ( two vali date d tests ) . Research ers were blinded to group allocation . Discussion The purpose of this paper is to outline the design of a school-based multicenter cluster r and omized , controlled trial aim ing to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerl and with a high migrant population .Trial Registration Trial Registration : clinical trials.gov Objective To investigate the associations between body composition , cardiorespiratory and muscular fitness in relation to travel mode to school in children and adolescents . Method Children and adolescents from 40 elementary schools and 23 high schools representing all regions in Norway were invited to participate in the study . Anthropometry , cardiorespiratory and muscular fitness  were tested at the school location . Question naires were used in order to register mode of transport to school , age , gender and levels of leisure time physical activity . Results A total of 1694 ( i.e. 60 % of all invited participants ) children and adolescents at a mean age of 9.6 and 15.6 respectively ( SD = 0.4 for both groups ) were analyzed for associations with physical fitness variables . Males cycling to school had lower sum of skin folds than adolescents walking to school . Higher cardiorespiratory fitness in adolescents and male cyclists compared to walkers and passive commuters were observed . Among children , cycling and walking to school , higher isometric muscle endurance in the back extensors compared to passive commuters was observed . Conclusion Based on this national representative cross-sectional examination of r and omly selected children and adolescents there is evidence that active commuting , especially cycling , is associated with a favourable body composition and better cardiorespiratory and muscular fitness as compared to passive commuting Little is known about the effectiveness of school-based health promotion on physical activity inequalities among children from low-income areas . This study compared the two-year change in physical activity among 10 - 11 year-old children attending schools with and without health promotion programs by activity level , body weight status , and socioeconomic background s to assess whether health promotion programs reduce or exacerbate health inequalities . This was a quasi-experimental trial of a Comprehensive School Health ( CSH ) program implemented in schools located in socioeconomically disadvantaged neighbourhoods in Edmonton , Alberta , Canada . In the spring of 2009 and 2011 , pedometer ( 7 full days ) and demographic data were collected from cross-sectional sample s of grade five children from 10 intervention and 20 comparison schools . Socioeconomic status was determined from parent self-report . Low-active , active , and high-active children were defined according to step-count tertiles . Multilevel linear regression methods adjusted for potential confounders were used to assess the relative inequity in physical activity and were compared between groups and over-time . In 2009 , a greater proportion of students in the intervention schools were overweight ( 38 % vs. 31 % p = 0.03 ) and were less active ( 10,827 vs. 12,265 steps/day p < 0.001 ) . Two years later , the relative difference in step-counts between intervention and comparison schools reduced from -15.5 % to 0 % among low-active students , from -13.4 % to 0 % among active students , and from -15.1 % to -2.7 % among high-active students . The relative difference between intervention and comparison schools reduced from -11.1 % to -1.6 % among normal weight students , from -16.8 % to -1.4 % among overweight students , and was balanced across socioeconomic subgroups . These findings demonstrate that CSH programs implemented in socioeconomically disadvantaged neighbourhoods reduced inequalities in physical activity . Investments in school-based health promotion are a viable , promising , and important approach to improve physical activity and prevent childhood obesity , and may also reduce inequalities in health Objective To assess the effectiveness of 2 interventions in improving the physical activity and well-being of secondary school children . Design A clustered r and omised controlled trial ; classes , 1 per school , were assigned to 1 of 3 intervention arms or a control group based on a 2 × 2 factorial design . The interventions were peer-mentoring and participative learning .  Year 7 children ( aged 11–12 ) in the peer-mentoring intervention were paired with year 9 children for 6 weekly mentoring meetings . Year 7 children in the participative learning arm took part in 6 weekly geography lessons using personalised physical activity and Global Positioning System ( GPS ) data . Year 7 children in the combined intervention received both interventions , with the year 9 children only participating in the mentoring sessions . Participants 1494 year 7 students from 60 schools in the North of Engl and took part in the trial . Of these , 43 students opted out of taking part in the evaluation measurements , 2 moved teaching group and 58 changed school . Valid accelerometry outcome data were collected for 892 students from 53 schools ;  and well-being outcome data were available for 927 students from 52 schools . Main outcome measures The primary outcomes were mean minutes of accelerometer-measured moderate-to-vigorous intensity physical activity per day , and well-being as evaluated by the KIDSCREEN-27 question naire . These data were collected 6 weeks after the intervention ; a 12-month follow-up is planned . Results No significant effects ( main or interaction ) were observed for the outcomes . However , small positive differences were found for both outcomes for the participative learning intervention . Conclusions These findings suggest that the 2 school-based interventions did not modify levels of physical activity or well-being within the period monitored . Change in physical activity may require more comprehensive individual behavioural intervention , and /or more system-based efforts to address wider environmental influences such as family , peers , physical environment , transport and educational policy . Trial registration number IS RCT N82956355 BACKGROUND : Concern has been raised regarding the increased prevalence of physical inactivity among children .  Active transportation , such as walking and cycling to school , is an opportunity for children to be physically active . OBJECTIVE : To identify the sociodemographic predictors of  active transportation to schools across time among school-aged children participating in the Canadian National Longitudinal Survey of Children and Youth ( NLSCY ) . METHODS : The sample included 7690 school-aged children attending public schools who were drawn from cycle 2 ( 1996 and 1997 ) of the Canadian NLSCY . Data were collected through interviews with the person most knowledgeable about the child . Parents were asked how their child usually gets to school . Responses were dichotomized into active ( walking or bicycling ) or inactive ( school bus , public transit , is driven , or multiple ) modes . Using 3 waves of data from the Canadian NLSCY ( 1996–2001 ) , we estimated the effect of sociodemographic factors on the likelihood  of active transportation to school across time using r and om-effects models . RESULTS : Longitudinal analyses indicated that as children aged , the likelihood of using active transportation to school increased , peaked at the age of 10 years , and then decreased . Urban setting s ( odds ratio [ OR ] : 3.66 [ 95 % confidence interval ( CI ) : 3.23–4.15 ] ) , households with inadequate income ( OR : 1.21 [ 95 % CI : 1.06–1.38 ] ) , living with 1 parent ( OR : 1.46 [ 95 % CI : 1.29–1.65 ] ) , and having an older sibling living at home ( OR : 1.14 [ 95 % CI : 1.04–1.25 ] ) were significant predictors of  active transportation to school at baseline and carried through across time . CONCLUSIONS : Underst and ing the factors that influence  active transportation  may support its adoption by children , which in turn may contribute to meeting physical activity guidelines Children with migration background ( MB ) appear to be at higher risk of developing obesity , therefore , prevention is necessary to avoid possible health inequalities . This study investigated a 1-year intervention with focus on increasing physical activity ( PA ) and fruit and vegetable intake ( FVI ) , decreasing screen media use ( SMU ) and  soft drink consumption ( SDC ) in children with MB . 525 children ( 7.1 ± 0.7 years ) with MB who participated in the cluster-r and omised study were assessed at baseline and after 1 year . Daily SMU , PA behaviours , SDC and FVI were assessed using a parental question naire . After one year , significant effects were found in the intervention group for FVI ( p ≤ 0.035 ) . Partially strong tendencies but no significant differences were found for PA and SDC . Although the effects are small , the intervention seems to reach children with MB . An intervention lasting longer than one year might result in more changes OBJECTIVE To evaluate the short and long term benefits of a school and home based physical activity " enrichment " program for children at higher risk of cardiovascular disease as identified by cluster analysis . STUDY DESIGN During two 10-week school terms , 800 11-year-olds took part in a r and omized controlled trial with the st and ard physical activity and nutrition program in six schools , the st and ard program in a further seven schools  but with the addition of physical activity enrichment for higher risk children in those schools  , and no program in five control schools . Cluster analysis identifying the 29 % or so highest risk children used systolic blood pressure , percent body fat , physical fitness , and blood cholesterol . RESULTS Fitness improved significantly in program schools , particularly with enrichment in higher risk boys . Substantial improvements persisted 6 months later in girls from program schools . At " Enrichment " schools , cholesterol showed significant benefits in higher risk girls and , 6 months later , in both boys and higher risk girls . Sodium intake and , in girls , subscapular skinfolds were lower in " Enrichment " schools when the program ended , but not 6 months later . CONCLUSION Two-semester health programs with physical activity enrichment for higher risk children can produce benefits sustained for at least 6 months . Improvements extend to lower risk children exposed indirectly to the enrichment . Attenuation of effects on diet and body composition in the longer-term suggest the need for on-going programs Background Walking and cycling to school could be an important regular source of physical activity in growing children . The aim of this 12 months prospect i ve observational study was thus to evaluate the effect of self-transportation to school on bone mineral accrual and gain in bone width in pre-pubertal children , both traits independently contributing to bone strength . Methods Ninety-seven girls and 133 boys aged 7–9 years were recruited as a part of the Malmö Pediatric Osteoporosis Prevention ( POP ) Study in order to evaluate the influence of self-selected school transportation for the accrual of bone mineral and bone width .  Children who walked or cycled to school were compared with  children who went by bus or car . Bone mineral content ( BMC ) was measured by dual energy X-ray absorptiometry ( DXA ) in the lumbar spine ( L2–L4 ) , third lumbar vertebra ( L3 ) and hip , and bone width was calculated at L3 and femoral neck ( FN ) . Changes during the first 12 months were compared between the groups . Subjective duration of physical activity was estimated by a question naire and objective level of everyday physical activity at follow-up by accelerometers worn for four consecutive days . All children remained in Tanner stage 1 throughout the study . Comparisons were made by independent student 's t-tests between means , ANCOVA and Fisher 's exact tests . Results There were no differences in baseline or annual changes in BMC or bone width when the transportation groups were compared . No differences were detected in objective ly measured daily level of physical activity by accelerometer . All children reached above 60 minutes of moderate to intense daily physical activity per day , the international recommended level of daily physical activity according to the United Kingdom Expert Consensus Group . Conclusion The everyday physical activity in these pre-pubertal children seems to be so high that the school transportation contributes little to their total level of physical activity . As a result , the choice of school transportation seems not to influence the accrual of bone mineral or gain in bone size during a 12-month follow-up period OBJECTIVE During hospitalization older people often experience functional decline which impacts on their future independence . The objective of this study was to evaluate a multifaceted transitional care intervention including home-based exercise strategies for at-risk older people on functional status , independence in activities of daily living ( ADLs ) and walking ability . METHODS A r and omized controlled trial was undertaken in a metropolitan hospital in Australia with 128 patients ( 64 intervention , 64 control ) aged over 65 years with an acute medical admission and at least one risk factor for hospital readmission . The intervention group received an individually tailored programme for exercise and follow-up care which was commenced in hospital and included regular visits in hospital by a physiotherapist and a registered nurse , a home visit following discharge and regular telephone follow-up for 24 weeks following discharge . The programme was design ed to improve health-promoting behaviours , strength , stability , endurance and mobility . Data were collected at baseline , then 4 , 12 and 24 weeks following discharge using the Index of ADL , Instrumental Activities of Daily Living ( IADL ) and the Walking Impairment Question naire ( WIQ ; modified ) . RESULTS Significant improvements were found in the intervention group in IADL scores ( P < 0.001 ) , ADL scores ( P < 0.001 ) and WIQ scale scores ( P < 0.001 ) in comparison to the control group . The greatest improvements were found in the first 4 weeks following discharge . CONCLUSIONS Early introduction of a transitional model of care incorporating a tailored exercise programme and regular telephone follow-up for hospitalized at-risk older adults can improve independence and functional ability Objectives To assess the behavioural and weight status outcomes in English children in a feasibility study of a novel primary school-based obesity prevention programme . Design Exploratory cluster r and omised controlled trial of the Healthy Lifestyles Programme . Setting Four city primary schools ( two control and two intervention ) in the South West of Engl and . Participants 202 children aged 9–10 years , of whom 193 and 188 were followed up at 18 and 24 months , respectively . No child was excluded from the study ; however , to be eligible , schools were required to have at least one single Year 5 class . Intervention Four-phase multicomponent programme using a range of school-based activities including lessons , assemblies , parents ' evenings , interactive drama workshops and goal setting to engage and support schools , children and their families in healthy lifestyle behaviours . It runs over the spring and summer term of Year 5 and the autumn term of Year 6 . Primary and secondary outcomes Weight status outcomes were body mass index , waist circumference and body fat st and ard deviation scores ( SDS ) at 18 and 24 months , and behavioural outcomes were physical activity , television ( TV ) viewing/screen time and food intake at 18 months . Results At 18 months of follow-up , intervention children consumed less energy-dense snacks and more healthy snacks ; had less ‘ negative food markers ’ , more ‘ positive food markers ’ , lower mean TV/screen time and spent more time doing moderate-vigorous physical activity each day than those in the control schools . Intervention children had lower anthropometric measures at 18 and 24 months than control children , with larger differences at 24 months than at 18 months for nearly all measures . Conclusions Results from this exploratory trial show consistent positive changes in favour of the intervention across all targeted behaviours , which , in turn , appear to affect weight status and body shape . A definitive trial is now justified Promoting active transport is an increasingly important focus of recent health promotion initiatives addressing the major public health concerns of car dependence , decreased levels of physical activity and environmental health . Using active transport that relies less on the use of private cars and more on alternatives such as walking , cycling and public transport has the potential to increase population levels of physical activity and to improve the environment . Over 12 months , a combined social and individualized marketing campaign was delivered to a cohort of r and omly selected health service employees ( n = 68 ) working at a health care facility in inner-city Sydney , Australia . Pre- and post-intervention surveys measured changes in mode of transport , awareness of active transport and attitudes towards mode of transport . Following the intervention , we found there was a reduction in the proportion of participants who drove to work 5 days per week and a decrease in trips travelled by car on weekends . In addition , there was high awareness of the intervention amongst participants and their underst and ing of the concept of active transport improved from 17.6 % at baseline to 94.1 % at the follow-up survey ( p < 0.01 ) . There was also a significant shift in attitudes , which suggested increased positive regard for active transport . Our findings suggest that a combined social and individualized marketing campaign in the workplace setting can increase the use of active transport for the journey to work and trips on weekends . However , before these findings are widely applied , the intervention needs to be tested in a controlled study with a larger sample size
Most studies focussed solely on active  travel  to and /or from school , and showed significant positive associations with physical activity .
The same relationship was detected for active travel to leisure-related places and independent mobility with physical activity .
An inverse relationship between active travel to school and weight status was evident but findings were inconsistent .
Studies on independent mobility suggested that children who have the freedom to play outdoors and travel actively without adult supervision accumulate more physical activity than those who do not .
Further investigation of children 's active travel to leisure-related destinations , measurement of diverse sedentary behaviour beyond simply screen-based activities , and consistent thresholds for objective ly measured sedentary behaviour in children will clarify the inconsistent evidence base on associations of active travel with sedentary behaviour and weight status
UNLABELLED Health benefits from  children 's independent mobility and active travel beyond school travel are largely unexplored .
OBJECTIVES This review synthesized the evidence for associations of independent mobility and active travel to various destinations with physical activity , sedentary behaviour and weight status .