Health effects of children's summer holiday programs: a systematic review and meta-analysis.

Emily Eglitis, Ben Singh, Timothy Olds, Rosa Virgara, Amanda Machell, Mandy Richardson, Kylie Brannelly, Aniella Grant, Jessica Gray, Terri Wilkinson, Zoe Rix, Grant R Tomkinson, Carol Maher

Journal: The international journal of behavioral nutrition and physical activity 2024;21(1):119

PMID: 39425115

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Plain Language Summary

Good childhood health lays the foundation for lifelong health and the prevention of chronic diseases. Summer programs show potential in promoting healthier movement behaviours in children and supporting healthy body weight during the summer months. This study aimed to determine the effectiveness of summer holiday programmes on the health behaviours and physical health of children and adolescents. This study was a systematic review and meta-analysis of 10 studies involving 1,446 participants. Two studies were (individually) randomised controlled trials and 8 studies were non-randomised controlled trials. Results showed that summer programmes had a small to moderate effect on increasing daily moderate-to vigorous-intensity physical activity, a moderate effect on decreasing time spent in sedentary behaviour, and a small effect on improving children’s adiposity. Programmes targeting children with overweight or obesity produced greater effects than those targeting general populations. There were no significant changes in diet (energy intake or quality) or cardiorespiratory fitness. Authors concluded that summer holiday programmes are effective for improving children’s physical activity and sedentary behaviours, but not their dietary behaviours.

Abstract

BACKGROUND

Unfavourable changes occur in children's health behaviours and outcomes during the summer holidays. This systematic review aimed to determine the effectiveness of summer holiday programs in mitigating these changes.

METHODS

Six databases (MEDLINE, JBI, PsychINFO, Embase, ERIC and Scopus) were systematically searched for experimental controlled studies that investigated programs of at least 5 days' duration conducted exclusively during the summer holiday period on school-aged children (5-18 years). Primary outcomes were moderate-vigorous physical activity and energy intake. Secondary outcomes were sedentary behavior, diet quality, adiposity, and cardiorespiratory fitness. Risk of Bias was assessed using the PEDro tool. Effect sizes were calculated using random-effects meta-analysis with narrative synthesis of effects by student or program characteristics.

RESULTS

Ten studies (two randomised controlled trials, and eight non-randomised controlled trials) involving 1,446 participants were included. Summer programs had a significant moderate effect on reducing sedentary behaviour (g= -0.59, 95%CI= -1.16, -0.03) and significant small effects on improving moderate-to-vigorous physical activity (g = 0.35, 95%CI = 0.02, 0.67) and adiposity (g= -0.25, 95% CI = -0.39, -0.10). No significant change was detected for cardiorespiratory fitness (g = 0.43, 95%CI= -0.32, 1.17), energy intake (g= -0.06, 95% CI -2.33, 2.22), or diet quality (g = 0.20, 95%CI= -0.43, 0.83). Summer program effectiveness did not appear to differ by child sociodemographic or program characteristics. Concerns regarding bias and high heterogeneity impacted results.

CONCLUSIONS

Summer programs show potential in promoting healthier movement behaviours in children and supporting healthy body weight during the summer months. Although evidence from the included studies has limitations, these programs produced small to moderate effect sizes and present promising health intervention opportunities for children. Future research with more rigorous study designs and comprehensive reporting is needed to confirm these findings and better understand the impact of summer programs on children's health.

PROSPERO REGISTRATION

CRD42023409795.

Address: Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, South Australia, 5000, Australia. [email protected].; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, North Terrace, Adelaide, South Australia, 5000, Australia.; Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.; Present address: College of Medicine and Public Health, Flinders University Sturt Road, Bedford Park, SA, 5042, Australia.; Department for Education, Government of South Australia, Adelaide, South Australia, Australia.; National Outside School Hours Services Alliance, Woodend, Australia.

DOI: 10.1186/s12966-024-01658-8

Patient Centred Factor

Mediators: Childhood obesity

Physical Environment

Psychosocial influences

Clinical Imbalances

Immune and inflammation Structural Integrity and Musculoskeletal

Modifiable Lifestyle Factors

Exercise and movement

Nutrition Evidence Keywords

BMI Obesity Overweight Adiposity Physical activity Body mass index Cardiorespiratory fitness Body weight Sedentary behaviour Body fat percentage

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MeSH Terms: Adolescent, Child, Child, Preschool, Humans, Adiposity, Cardiorespiratory Fitness, Child Behavior, Diet, Energy Intake, Exercise, Health Behavior, Health Promotion, Holidays, Randomized Controlled Trials as Topic, Seasons, Sedentary Behavior