The outcomes of growth hormone therapy in the obstructive sleep apnea parameters of Prader-Willi syndrome patients: a systematic review.

PURPOSE: Prader-Willi syndrome is a serious genetic condition, capable of causing endocrinological imbalance, which has as one of its main treatments the growth hormone therapy. However, this therapy still causes some uncertainty concerning its effects on the respiratory parameters of those patients, especially in cases of obstructive sleep apnea, therefore, presenting a need for the analysis of the relationship between the therapy and the otolaryngologic condition. METHODS: A systematic review following the PRISMA model was developed, with searches for keywords made in the databases PubMed (MEDLINE), Scopus, and Web of Science and registration in the PROSPERO platform (CRD42023404250). RESULTS: Three randomized controlled trials were considered eligible for inclusion in the review. None of the studies demonstrated statistically significant modifications in the obstructive sleep apnea parameters of Prader-Willi patients related to the growth hormone administration. CONCLUSIONS: Growth hormone therapy is safe for Prader-Willi syndrome patients when analyzing their obstructive sleep apnea parameters.

Are low-income preschoolers physically active at preschool settings? A cross-sectional study.

BACKGROUND: Preschools may provide opportunities for children to engage in physical activity (PA), to benefit their health, although little is known when concerning low-income preschoolers. This study aimed (1) to describe time spent in PA among low-income children during preschool hours and (2) to analyse how many children meet the PA recommendations during preschool hours. METHODS: A total of 204 low-income preschoolers (4.51 ± 0.79 years) from João Pessoa/Brazil provided valid accelerometer (Actigraph, WGT3-X) data during the preschool period. Children were grouped in quartiles of PA in counts per minute, according to sex and age. The General Linear Model Univariate was used to examine the differences in PA intensities between the quartiles and the time spent in total PA (TPA) and moderate-to-vigorous PA (MVPA) by quartiles, according to age. An hour-by-hour description of children's PA was presented. RESULTS: TPA during preschool hours ranged from 68.33% to 113.89% of the recommended and from 28.34% to 81.68% of the MVPA recommendations. Among 5-year-old children, those in the highest quartile met the PA recommendations. All children were more active outdoors than indoors. For the less actives, preschool time corresponded to 30% of the recommended daily MVPA. CONCLUSION: The current results reinforce the importance of preschool settings for promoting preschoolers' PA and provide particularly important and useful information for tailoring preschool-based interventions focused on those who need it most. Strategies to increase children's MVPA should be prioritized during free-play time.

Home-based interventions to promote physical activity for people living with HIV - a systematic review.

Although physical activity (PA) improves the physical, mental, and social outcomes of people living with HIV (PLH), multiple barriers prevent them from exercising. In this systematic review, we investigated the effect of home-based interventions to promote physical activity (HBI) among PLH. Randomised trials and quasi-experimental studies published in English until March 2020 were sought in five databases. Independent reviewers performed data extraction, risk of bias assessment and pragmatic-explanatory (PRECIS-2) evaluation of study characteristics. Outcomes included engagement in PA, body composition, cardiorespiratory fitness, strength, metabolic disturbances, and quality of life (QoL). Out of 480 retrieved references, six studies met inclusion criteria. Interventions lasted 12-48 weeks and involved 400 individuals (57.8% women). Ninety-eight (24.5%) participants completed interventions, but dropout rates varied considerably (5.0-54.5%). Resulted showed increased PA (two studies) and improved cardiorespiratory fitness or strength (three and two studies, respectively). Four studies demonstrated reduction of waist circumference and increase in lean body mass. QoL improved in two of three studies. We conclude HBI (aerobic and/or resistance exercises) may contribute to improve PA and/or cardiorespiratory fitness, body composition, strength and QoL of PLH. Further investigation using multi-centre standardised protocols is warranted to provide stronger evidence of their effectiveness in health promotion for PLH.

Mobile health apps to reduce sedentary behavior: a scoping review.

Given the continued increase in mobile health applications (apps) aimed at healthcare and the recognition of sedentary behavior (SB) as a public health problem, the goal of this scoping review study was to summarize the effects of interventions based on mobile health apps designed to reduce SB in adults, with a specific focus on SB. The electronic databases PubMed, PsycINFO, SportDISCUS, Web of Science, and manual searches in reference lists were conducted on papers published up to September 2020. Nine out of the 897 studies researched were included and composed the descriptive synthesis. The investigations found in the present study showed a decrease in time spent on television viewing and in total time spent sitting, as well as an increase in the number of SB breaks after interventions based on mobile health apps. In conclusion, despite the growing interest in intervention programs in SB, only nine studies have used smartphone apps as a strategy to reduce SB in adults. Mobile health apps were proved to be effective in SB reduction, as assessed by different parameters, and should be encouraged. However, further studies are needed to verify the long-term effects of the utilization of such applications.

[Remote control or unlikely control? Behavioral economics and the promotion of healthy behaviors¿Control remoto o remota probabilidad de control? La economía comportamental y la promoción de determinados patrones de comportamiento]. / Controle remoto ou remoto controle? A economia comportamental e a promoção de comportamentos saudáveis.

Behavioral economics is a field of knowledge and practices that studies the effect of psychological, cognitive, emotional, and social factors relating to decision-making by individuals and institutions. It assumes that human choices are not the result of careful consideration of costs and benefits, and that some aspects (e.g., defaults, framings, and anchoring effects) may influence an individual's decision-making. Thus, the aim of this essay is to present some general aspects of behavioral economics and discuss its possible application in the promotion of healthy behaviors. One of the roles of health care professionals is to facilitate the adoption of healthy behaviors by the population. There is evidence of a positive influence of some behavioral economics concepts regarding the adoption of various health behaviors, such as food choices, physical activity, adherence to vaccination campaigns, and organ donation. Thus, it is believed that the appropriation of some of these concepts and insights may both promote healthier behaviors and support more effective actions to encourage these healthy behaviors.

La economía comportamental es un campo de conocimientos y prácticas que estudia el efecto de los factores psicológicos, cognoscitivos, emocionales y sociales sobre la toma de decisiones de las personas y las instituciones. Esa disciplina parte de la premisa de que las formas de elección humana no son el resultado de una cuidadosa ponderación de los costos y beneficios, y de que algunos aspectos (por ejemplo, la opción predeterminada, el efecto de enmarcación y el efecto de anclaje) pueden influir en la toma de decisiones por parte de las personas. Por ende, el objetivo de este texto es presentar los aspectos generales de la economía comportamental y algunas reflexiones sobre su posible aplicación en la promoción de patrones de comportamiento saludable. Una de las funciones de los profesionales de salud es facilitar la adopción de patrones de comportamiento saludable por parte de la población. En esa perspectiva, se ha comprobado que la aplicación de los conceptos de la economía comportamental puede tener un efecto positivo en la adopción de diversos patrones de comportamiento en materia de salud, por ejemplo, la selección de alimentos, la práctica de la actividad física, la adhesión a campañas de vacunación y la donación de órganos. De ese modo, se cree que la apropiación de algunos conceptos y percepciones de la economía comportamental permite, por un lado, promover los patrones de comportamiento saludable y, por otro, apoyar medidas más eficaces para incentivar esos tipos de comportamiento.

Preventing obesity among Brazilian adolescent girls: Six-month outcomes of the Healthy Habits, Healthy Girls-Brazil school-based randomized controlled trial.

BACKGROUND: School-based trials to prevent and reduce prevalence of pediatric obesity in low-income countries are necessary. In Brazil, addressing adolescent obesity is a public health priority. OBJECTIVE: To evaluate the impact of a group randomized controlled trial involving a 6-month multicomponent school-based obesity prevention program targeting adolescent girls. METHODS: The Healthy Habits, Healthy Girls-Brazil program recruited participants (n=253; 16.05±0.05 years) from ten eligible public technical schools in São Paulo, Brazil. The program was adapted from an Australian intervention study, which is based on the Social Cognitive Theory. The primary outcome measure was body mass index (BMI), and secondary outcomes included BMI z score, waist circumference, and various sedentary and dietary health-related behaviours. RESULTS: Although changes in BMI were not statistically significant, differences favored the intervention group (adjusted mean difference, -0.26kg/m(2),se SE=0.018, p=0.076). Statistically significant intervention effects were found for waist circumference (-2.28cm; p=, p=0.01), computer screen time on the weekends (0.63h/day, p; p=0.02), total sedentary activities on the weekends (-0.92h/day, p<0.01), and vegetable intake (1.16servings/day, p=0.01). CONCLUSION: These findings provide some evidence for the benefit of a school-based intervention to prevent unhealthy weight gain in adolescent girls living in low-income communities.

Systematic review of physical activity promotion by community health workers.

OBJECTIVE: To assess the physical activity promotion in interventions conducted by community health workers. METHODS: Systematic searches in five electronic databases (LILACS, PubMed, Scopus, Web of Science and SportDiscus) and manual searches in reference lists were conducted for papers published up until May 2014. The inclusion criteria were interventions delivered in adults by community health workers that had physical activity promotion as an objective (primary or secondary). RESULTS: Of the 950 references initially retrieved, 26 were included in the descriptive synthesis. At the operational level, action strategies were predominantly based on the model of health education grounded in counseling, and delivered in populations at risk or diagnosed with chronic non-communicable diseases. Only five studies had the primary outcome of physical activity promotion and twenty-five studies used self-report methods for evaluation. The majority of studies (72.4%) were classified as having low or moderate risk of bias. Sixteen studies (61.5%) reported positive results for different parameters of physical activity. Most studies were carried out in the United States. The successful interventions were conducted over a period averaging 6.5 months and targeted mainly women, individuals older than thirty, specific ethnic groups, and syndromic or at-risk individuals. CONCLUSIONS: The community health workers were important for physical activity promotion, but further interventions should be carried out in different countries and less specific samples, that include physical activity as a primary outcome and employ direct methods for assessing physical activity.

School-based physical activity and nutritional education interventions on body mass index: a meta-analysis of randomised community trials - project PANE.

OBJECTIVE: To evaluate the effect of school-based physical activity (PA) and nutritional education (NE) interventions on children's and adolescents' body mass index. METHODS: We conducted a systematic search in fourteen databases until September 2012 for randomised controlled trials on PA and NE, conducted in the school setting, and delivered to children and adolescents. Additionally, we performed a cross-reference check in related papers. The title and abstract review and the quality assessment were performed by two independent researchers. The software EPPI-Reviewer3 was used to store, manage and analyse all data. The meta-analysis was conducted using the random-effects model, and the outcomes were reported as standardised mean difference (SMD). As a secondary analysis, we pooled together the interventions that considered PA or NE alone. RESULTS: Thirty-eight studies met the eligibility criteria. The main analysis showed a SMD between intervention and control groups of -0.03 (95% CI: -0.09, 0.04; n=28,870; I(2)=83%). When we considered all 57 trials, there was no difference between the results of the primary analysis. CONCLUSION: The synthesis of school-based PA and NE interventions showed no statistically significant mean reduction on children's and adolescents' body mass index. The high heterogeneity among studies requires caution in the generalisation of the results.

Association between the environment for physical activity in public schools and childhood obesity: a view in the light of complex systems.

This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

The effect of participation in school-based nutrition education interventions on body mass index: a meta-analysis of randomized controlled community trials.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of school-based nutrition education interventions in reducing or preventing overweight and obesity among children and adolescents. METHODS: We conducted a systematic search of 14 databases until May 2010 and cross-reference check in 8 systematic reviews (SRs) for studies published that described randomized controlled trials conducted in schools to reduce or prevent overweight in children and adolescents. An additional search was carried out using PubMed for papers published through May 2012, and no further papers were identified. Body mass index (BMI) was the primary outcome. The title and abstract review and the quality assessment were performed independently by two researchers. The software EPPI-Reviewer3 was used to store, manage and analyze all data. This SR is registered at ClinicalTrials.gov (NCT00985972). RESULTS: From the 4888 references initially retrieved, only 8 met the eligibility criteria for a random-effects meta-analysis. The total population consisted of 8722 children and adolescents. Across the studies, there was an average treatment effect of -0.33 kg/m(2) (-0.55, -0.11 95% CI) on BMI, with 84% of this effect explained by the highest quality studies. CONCLUSION: This systematic review provides evidence that school-based nutrition education interventions are effective in reducing the BMI of children and adolescents.

Stand Up for Yourself: Tackling Sedentary Behavior through Exercise and Lifestyle.

Because of their direct relations to the process of health and disease throughout life, physical activity and sedentary behavior emerge as priorities in the global public health agenda [...].

Effectiveness of the 5A Counseling Model-Based Interventions on Physical Activity Indicators in Adults: A Systematic Review.

BACKGROUND: To identify and appraise the effectiveness of the 5A-counseling-model-based interventions on indicators of physical activity in adults. METHODS: A systematic review was conducted from systematic searches in Embase, Lilacs, Pubmed, Scielo, Scopus, Sportdiscus and Web of Science, involving studies published from its inception until May 2022. To avoid potential losses, searches also were made in Google Scholar and in reference lists. The assessment of studies, data extraction, and synthesis were carried out independently by two researchers. RESULTS: Four studies composed the synthesis, which involved people with an average age between 40 and 55 years, most of the samples being women. It was observed that counseling was carried out in conjunction with other strategies, such as drawing up an action plan, sending text messages, and offering educational material. Only one study showed a statistically significant difference between the intervention and control groups in the "daily number of steps" indicator. CONCLUSIONS: Based on available studies, 5A-counseling-model-based interventions did not reflect significant findings in relation to physical activity. However, given the potential of the model, future studies are recommended with a better description of the strategies, as well as a more robust methodology, to strengthen the evidence.

Screen time and low back pain in children and adolescents: a systematic review of Brazilian studies.

OBJECTIVE: To identify and summarize the possible associations between screen time and low back pain in children and adolescents. DATA SOURCE: Systematic searches were performed in five electronic databases (Lilacs, Scielo, Scopus, PubMed and Web of Science) on 01/25/2021, complemented by manual searches in reference lists and on Google Scholar, looking for original scientific articles that included Brazilian observational studies; whose samples had children and/or adolescents aged between 6 and 19 years, without specific clinical conditions, and that presented analyses of associations between indicators of screen time and nonspecific low back pain, based on regression models. DATA SYNTHESIS: Nine cross-sectional studies whose samples had adolescents were included. Of the 18 analyses identified, nine reported risk relationships between the variables of interest. More specifically, risk associations were found in two studies that evaluated adolescents exposed to at least three hours using cell phone or tablet, and watching television per day. Also, instruments, cut-off points adopted, and screen equipment evaluated were diverse. CONCLUSIONS: Even though most of the risk associations were borderline from the statistical point of view, we found a higher frequency of risk associations between screen time and non-specific low back pain in adolescents exposed to screen time for at least three hours a day. In addition, further longitudinal studies with samples composed of children should be conducted across the country.

Common mental disorders among medical students: systematic review and meta-analysis of Brazilian studies.

BACKGROUND: Common mental disorders (CMDs) have been correlated with consequences in different domains of life. OBJECTIVE: To summarize the prevalence rates of CMDs and factors associated with them among students at Brazilian medical schools. DESIGN AND SETTING: Systematic review and meta-analysis of studies developed in Brazilian medical schools. METHODS: In October 2021, searches were carried out in seven electronic databases, in Google Scholar and in reference lists. Observational studies reporting prevalence rates of CMDs among students at Brazilian medical schools were sought. Variables associated with CMDs arising from multivariate regression models were included in the synthesis. A meta-analysis was developed using a random-effects model and the risk of bias was assessed using an instrument developed from previous references. RESULTS: Fourteen original studies were included. The pooled prevalence rate of CMDs among undergraduate students at Brazilian medical schools was 43.3% (95% confidence interval = 38.9% to 47.6%; I2 = 87%; n = 3,927). Among the nine studies in which multivariate analyses were conducted, five showed risk associations between CMDs and medical school-related dissatisfactions, among which the desire to abandon the medical course can be highlighted (n = 3). In three studies, CMDs were associated with sleep indicators. CONCLUSION: Considering that the prevalence of CMDs among medical students is higher than in the general population, we recommend that Brazilian medical schools should give greater attention to this topic, and should enable expansion of care offerings relating to mental health. SYSTEMATIC REVIEW REGISTRATION: Prospective Register of Systematic Reviews (PROSPERO) database (CRD42020142184).

Association between Different Domains of Sedentary Behavior and Health-Related Quality of Life in Adults: A Longitudinal Study.

Extended periods of time on screen devices and sitting are the main activities that characterize sedentary behavior (SB), which negatively impacts the quality of life. This negative influence was demonstrated mainly by cross-sectional studies performed in high-income countries in which the effects of screen time on health-related quality of life (HRQoL) is not considered. Thus, we analyzed the association between the different domains of SB (i.e., subdomains of screen time-television, computer, cellphone) and the HRQoL in adults that live in Brazil during two years of follow-up. The sample included 331 adults. Subdomains of screen time (i.e., watching television, using computers, and cellphones) and of HRQoL (i.e., physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, and current health perception) were assessed by a structured questionnaire and SF-36, respectively. Our results indicate a significant increase in screen time during the two years of follow-up. Linear regression models indicated that although domains of SB were differently associated with HRQoL, in general, screen time was negatively associated with social functioning and positively associated with physical functioning during locomotion and activities of daily living (ADL), role-physical (i.e., physical issues during work and ADLs), and role-emotional (i.e., emotional issues during work and ADLs) after the two-year follow-up. In conclusion, screen time may positively or negatively influence some domains of HRQoL in adults.

Muscular strength and cardiovascular risk factors in adults: a systematic review.

OBJECTIVE: The purpose of this study was to identify and summarize the relationships between MS and individual components of metabolic syndrome (MetS) [high waist circumference (WC), high blood pressure (BP), high systolic blood pressure (SBP), high diastolic blood pressure (DBP), high triglycerides (TG), fasting blood glucose (GL) and low HDL cholesterol levels (HDL-C)] in adults. METHODS: A systematic review was performed on six electronic databases (Lilacs, Pubmed, Scielo, Scopus, Sportdiscus, and Web of Knowledge), with complimentary searches in reference lists. The databases were investigated without restrictions regarding the period of publication. RESULTS: Of the 6,833 articles initially identified, 17 were included, with data on 43,343 adults. Higher MS values were associated with lower WC values. Different results in relation to the association between MS and BP, MS and SBP, and MS and DBP were verified. In addition, inconclusive results were verified in the relationship between MS and TG, MS and HDL-C, and MS and GL. CONCLUSION: Higher MS values were related with lower WC in adults. More evidence from longitudinal studies with high methodological rigor is needed to elucidate the relationship between MS and CVD among adults.

[Identification and analysis of national physical activity guidelines in the Americas]. / Identificação e análise das diretrizes nacionais de atividade física nas Américas.

Given the potential of institutional approaches to health promotion, this study sought to identify the countries on the American continent which have national physical activity (PA) guidelines approved by their national health agencies. A scoping review was conducted in May 2019, with a search conducted in five electronic databases, national health agency websites and contacts with members of the Physical Activity Network of the Americas. In all, national PA guidelines were found in ten of the 36 countries surveyed (27.8%), published between 2011 and 2018, the majority being in South American countries (n = 6). All guidelines presented "approaches and strategies for primary health care," "PA recommendations for health," and the "involvement of different PA domains," however, few guidelines addressed "constructed environment and infrastructure" (n = 3), as well as "monitoring and surveillance actions" (n = 5). The conclusion can be drawn that, although few countries on the American continent have guidelines for PA and that the majority of those available address PA in a limited way, new national guidelines, based on the complexity of the determinants, monitoring and consequences of PA are needed to guide and foster policies to promote PA within the population.

Visto o potencial das abordagens institucionais à promoção da saúde, o presente estudo buscou identificar os países do continente americano que possuem diretrizes nacionais de atividade física (AF) chanceladas por órgãos nacionais de saúde. Em maio de 2019 realizou-se uma revisão de escopo, com buscas em cinco bases de dados eletrônicas, sítios eletrônicos dos órgãos nacionais de saúde e contato com integrantes da Rede de Atividade Física das Américas. Foram encontradas diretrizes nacionais de AF em dez dos 36 países pesquisados (27,8%), publicadas entre 2011 e 2018, com maioria nos países da América do Sul (n=6). Todas as diretrizes apresentaram "abordagens e estratégias para a atenção primária em saúde", "recomendações de AF para a saúde" e o "envolvimento de distintos domínios da AF", contudo, poucas diretrizes abordaram o "ambiente construído e infraestrutura" (n=3), assim como "ações de monitoramento e vigilância" (n=5). Pode-se concluir que, ao passo que poucos países do continente americano dispõem de diretrizes para a AF e, que boa parte das disponíveis aborda a AF de maneira limitada, novas diretrizes nacionais, fundamentadas na complexidade dos determinantes, monitoramento e consequências da AF são necessárias para a orientação e incentivo de políticas de promoção da AF no contexto populacional.

Effects of community health worker-based interventions on physical activity levels in children: a systematic review.

OBJECTIVE: To identify the strategies and effects of interventions carried out by community health workers (CHW) on physical activity (PA) levels in children and adolescents. DATA SOURCE: In August 2020, a systematic review, designed according to the PRISMA checklist items, was conducted by searches in seven electronic databases and in reference lists. Original studies were searched without restriction with regard to year of publication; they were written in Spanish, English or Portuguese and examined interventions implemented by CHW, involving theoretical and/or practical contents of PA, with a focus on children and/or adolescents between three and 19 years of age. DATA SYNTHESIS: Of the 2,321 studies initially retrieved, eight were included, targeting samples with more specific characteristics (e.g., clinical, ethnic and/or socioeconomic). In all studies, CHW were trained to lead educational activities. In three non-controlled trials, positive results were observed, involving indicators such as moderate and vigorous PA and physical inactivity reduction. Also, two positive results were found in reducing sedentary behavior. CONCLUSIONS: Even though most of the interventions included did not have a significant effect on increasing PA levels, the available findings reinforce the role of CHW as an important strategy for dialogue between health services and the most vulnerable communities, and they suggest a greater articulation of these professionals in the actions developed in the school context.

Sedentary behavior and motor competence in children and adolescents: a review.

OBJECTIVE: To synthesize evidence from studies that analyzed the associations between sedentary behavior and motor competence in children and adolescents. METHODS: Systematic review of original articles that analyzed possible associations between sedentary behavior and motor competence in children and adolescents (3-18 years of age), without restrictions on study design, instruments and analysis protocols. The articles were identified through searches in the PubMed, Web of Science, Academic Search Premier, Cinahl, Medline and SPORTDiscus databases, as well as in reference lists. The level of evidence was evaluated according to the amount of studies that reported statistical significance in the associations between the variables and the quality of the articles (risk of bias). RESULTS: Of 2,462 initial studies, 22 composed the synthesis (two interventions, nine longitudinal and eleven cross-sectional studies). Of these, in 13, we observed negative associations between the variables, more often in the age group of seven to fourteen years. In the analysis of risk of bias, the main limitations of the studies were "convenience sampling" and "no description of sample sizing". CONCLUSIONS: The available evidence suggests that sedentary behavior is negatively associated with motor competence in elementary school children, although the evidence is uncertain in the preschool years; the synthesis of results from longitudinal studies suggests that sedentary behavior negatively affects the development of motor competence. It is important that future studies have greater control over sociocultural determinants and deepen knowledge regarding sex and age, as well as the methods and indicators used to evaluate the two variables.

Effects of interventions for promoting physical activity during recess in elementary schools: a systematic review.

OBJECTIVE: Summarize the effects of interventions designed to promote physical activity during elementary school recess in children between 5 and 10 years old. Effective school interventions for children can promote physical activity and healthy behaviors. METHODS: PubMed, Scopus, Bireme, SciELO, Web of Science, PsychINFO, Proquest, Physical Education Index, Sports Discus, and Eric databases were included in the data search. Original intervention articles on physical activity that used regression methods, published between 2000 and 2019 in English, Portuguese and Spanish were analyzed. Analyses were performed in 2019. Outcomes were organized according to the direction of the association by independent variables. Ten articles were considered eligible for data extraction and evaluation. RESULTS: Several strategies were used including playground markings, demarcation of physical activities zones, group activities, availability of sports equipment and facilities. Most of the studies were conducted in the United States. Recess periods ranged from 20-94 min per day and intervention time ranged from 6 weeks to 2 years. Recess duration and intervention effects were positively associated with physical activity. Gender (girls) and age (oldest) were negatively associated with physical activity during recess. CONCLUSIONS: Interventions based on modifications of school environment such as playground markings demarcation of physical activities zones, group activities, availability of sports equipment and facilities are cheap and cost-effective for increasing physical activity in school recess.