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American Journal of Health Education
ISSN: 1932-5037 (Print) 2168-3751 (Online) Journal homepage: https://www.tandfonline.com/loi/ujhe20
Sedentary Time and Behavior during School: A
Systematic Review and Meta-Analysis
Catherine A. Egan, Collin A. Webster, Michael W. Beets, R. Glenn Weaver,
Laura Russ, Daniel Michael, Danielle Nesbitt & Karie L. Orendorff
To cite this article: Catherine A. Egan, Collin A. Webster, Michael W. Beets, R. Glenn Weaver,
Laura Russ, Daniel Michael, Danielle Nesbitt & Karie L. Orendorff (2019): Sedentary Time and
Behavior during School: A Systematic Review and Meta-Analysis, American Journal of Health
Education
To link to this article: https://doi.org/10.1080/19325037.2019.1642814
Published online: 03 Sep 2019.
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Sedentary Time and Behavior during School: A Systematic Review and
Meta-Analysis
Catherine A. Egan
a
, Collin A. Webster
b
, Michael W. Beets
b
, R. Glenn Weaver
b
, Laura Russ
b
, Daniel Michael
c
,
Danielle Nesbitt
b
, and Karie L. Orendorff
b
a
University of Idaho;
b
University of South Carolina;
c
Longwood University
ABSTRACT
Background: Sedentarism is uniquely associated with numerous health problems (e.g., obesity).
School-age youth spend a considerable portion of their time being sedentary, although relatively
little attention has been given to examining youth sedentary time or behaviors during school.
Purpose: This systematic review and meta-analysis examined sedentarism (time, behaviors) in
children and adolescents during school hours. Methods: Two separate electronic-databases
searches were conducted. The first focused on sedentary time and looked for studies that: (1)
were conducted in the U.S., (2) targeted the K-12 setting during school-day hours, (3) were an
intervention, (4) included objective measures, and (5) reported sedentary outcomes as a time-
based metric. The second search focused on sedentary behavior and looked for studies that: (1)
were conducted in the U.S., (2) targeted the K-12 setting during school-day hours, and (3)
included reporting of sedentary behaviors. A pooled estimate of percent-time spent sedentary
was calculated. Results: On average, youth spent 63% of their time in school sedentary. There
were no studies that met the inclusion criteria for the sedentary behavior portion of the review.
Discussion: The limited number of studies found that report sedentary-time, coupled with the
absence of studies describing sedentary behaviors, suggests that further descriptive research is
needed to understand school-based sedentarism in youth. Translation to Health Education
Practice: Professional development for school staff and intervention work should encompass
sedentary time and behaviors across the school day.
ARTICLE HISTORY
Received 20 December 2018
Accepted 8 March 2019
Background
The Institute of Medicine uses the term “sedentarism”to
refer to sedentary behaviors, sedentary activities,
a sedentary lifestyle, or physical inactivity. Sedentarism
can be understood both in terms of the time spent being
inactive and the types of behaviors that comprise inactive
time. For instance, a commonly employed definition of
sedentarism is “time spent other than in sleep, or time
spent in vigorous-, moderate-, or light-intensity physical
activity.”
1
However, other definitions focus on the beha-
vioral aspects of the concept. Tremblay et al.
2
state that
sedentary behavior is any waking behavior characterized by
energy expenditure ≤1.5 metabolic equivalents (METs),
while in a sitting, reclining or lying posture.
Sedentarism is distinct from physical activity (PA)
3
and
is an important health concern in its own right.
1
Though
a conservative interpretation of the extant literature has
been recommended,
4
the research on health consequences
associated with sedentarism is steadily growing.
5
Studies
with adults demonstrate that excessive amounts of time
spent sitting in various activities is linked to chronic
diseases such as cardiovascular disease, obesity, and type 2
diabetes.
6
Data from a cohort study in the U.S. with 7,744
men showed that participants who reported spending 10 or
more hours in a car per week had an 82% higher risk of
cardiovascular disease mortality than those who reported
spending less than 4 h.
7
InastudywithaCanadiansample
of 42,612 participants, men and women who watched tele-
visionformorethan21hperweekhadsignificantlyhigher
rates of obesity (25% and 24%, respectively) than their
counterparts who watched 5 h per week (14% and 11%,
respectively), regardless of participation in PA.
8
Furthermore, in another U.S.-based study, results from
a sample of 68,497 women indicated that spending two
additional hours of sitting at work was associated with an
increase (7%) in developing type 2 diabetes, independent of
PA levels.
9
In youth, sedentarism increases during the transition
from elementary to secondary school years.
10
Areviewof
studies that used accelerometers to measure the amount of
time youth spend sedentary found that children (6–11)
spent an average of about 6.1 h/day sedentary, while
CONTACT Catherine A. Egan eganca@uidaho.edu Department of Movement Sciences, University of Idaho, 875 Perimeter Drive MS 2401, Moscow,
ID 83844
AMERICAN JOURNAL OF HEALTH EDUCATION
https://doi.org/10.1080/19325037.2019.1642814
© 2019 SHAPE America
adolescents (12–15 and 16–19) spent an average of 7.5 h/
day and 8.0 h per day sedentary, respectively.
11
Increases in
sedentarism over time in children and adolescents were
associated with increases in adiposity.
12
Moreover, from
ages 9–15, increases in time spent sedentary (1 h/day) was
associated with increases in body mass index (BMI), inde-
pendent of moderate-to-vigorous PA.
13
The Institute of Medicine
1
uses the terms recreational
and non-recreational sedentarism to refer to inactive per-
iods during leisure time and work/school time, respec-
tively. Descriptive research on youth sedentarism has
mainly focused on non-recreational sedentarism.
14
In
a systematic review of children’s sedentarism after
school,
15
children spent an average of 41% of their time
sedentary in after school care and 51% of their time
sedentary in other locations. Adolescents spent 57% of
their time sedentary. Sedentary behaviors included televi-
sion viewing (20% of the time), non-screen-based beha-
viors (20%), homework/academics (13%), motorized
transport (12%), social behaviors (9%), and screen-based
behaviors excluding television viewing (6%).
15
Sedentarism during school is a concern, given the large
amount of time youth spend in this setting. A sample of 571
children (7–12 years old) in Brazil spent an average of 132-
min sedentary during school (64% of total schooltime),
with girls, obese children, older children, and those who
did not have physical education spending more time seden-
tary than their peers.
16
In another study,
17
children (6–8
years old) in the United States (N = 61) and Finland (N =
139) were sedentary during school 38.8 min/hour and 36.4
min/hour, respectively. Abbott, Straker, and Mathiassen
18
found that 53 children (10–12 years old) in Australia and
New Zealand spent more time in sustained sedentary beha-
vior (uninterrupted sedentary behavior for 30 min or more)
during school than out of school. Furthermore, a sample of
76 third and fourth-grade children in the U.S. did not
compensate for sedentary time during school by being
more active after school, and they were more active after
school on days they were more active during school (i.e.,
days with physical education and recess).
19
Purpose
The American Academy of Pediatrics and the National
Heart, Lung, and Blood Institute
20
recommend no more
than 2 h per day of screen time. However, no specific
guidelines exist in the U.S. for school-based sedentarism.
Synthesizing the existing research describing youth
sedentary time and behavior during school would assist
policy-makers in determining appropriate recommenda-
tions for school practices. The purpose of this systematic
review, therefore, was to collate the existing research
describing school-based sedentary time and behavior in
youth and determine (a) the amount of time children
and adolescents spend sedentary during school, and (b)
the types of behaviors youth engage in during this time.
Methods
Evidence acquisition
Search strategy for sedentary time
Studies were identified and analyzed between
February 1 2015 and February 28 2016. Four reviewers
conducted independent searches using two electronic
databases (GoogleScholar and PubMed) using the fol-
lowing combinations of keywords: school, accel*, accel-
erometer, and physical activity. After an initial list was
generated, researchers conferred to verify the same
number of hits from each database with 100% agree-
ment. Results from each electronic database search
were further analyzed by title and abstract according
to the PRISMA guidelines.
21,22
Existing review articles
on youth sedentary time were also identified and their
references searched for inclusion of studies.
Search strategy for sedentary behaviors
Studies were identified and analyzed between April 1 2017
and May 30 2017. One reviewer conducted an indepen-
dent search using two electronic databases (GoogleScholar
and PubMed) using the following combinations of key-
words: school, behavior, behaviors, and behavior*. After
the initial list was generated, the second author confirmed
the search and verified the same number of hits from each
database as well as randomly chosen (1st, 5th, and 10th)
page results with 100% agreement. Two reviewers exam-
ined results from each electronic database by title and then
abstract according to PRISMA guidelines.
21,22
Youth
sedentary behavior reviews were identified and searched
for inclusion of studies.
Inclusion criteria for sedentary time
Articles were included in this review that (1) occurred in the
United States, (2) targeted the K-12 setting (students 3–18
years old) during school day hours, (3) were an intervention
(not restricted to randomized controlled trials), (4)
included objective measurements (e.g., accelerometry), (5)
reported sedentary outcomes as a time-based metric (i.e.,
percentage of school day spent being sedentary), and (6)
were not published after February 28 2016.
Inclusion criteria for sedentary behaviors
Studies were included in this review that (1) occurred
in the United States, (2) targeted the K-12 setting
(students 3–18 years old) during school day hours, (3)
2C. A. EGAN
reported sedentary behaviors, and (4) were not pub-
lished after February, 28th, 2016.
Literature search
Sedentary time
A total of 2,021 records were identified and the
abstracts of 497 records were screened by four
reviewers. Of these, 165 full-text documents were iden-
tified for inclusion. Disagreements were discussed until
consensus was reached. A final count of nine studies
23–
31
met the inclusion criteria and were included in
systematic review and meta-analysis (Figure 1).
Sedentary behaviors
A total of 1889 records were identified and the abstracts of
280 records were screened by two reviewers. Of these, 156
full-text documents were identified for inclusion.
Disagreements were discussed until consensus was
reached. At the conclusion of full text screening, there
were no studies that met the inclusion criteria (Figure 2).
Data extraction
Sedentary time
Four reviewers extracted from each study information
regarding study design, participants, sample size, length of
intervention, primary outcomes, secondary outcomes,
sedentary time measurements, context, and risk of bias.
Congruent with items from the Cochrane Group’s tool
and previous research,
32
risk of bias was identified as the
presence/absence of blinding participants/personnel and/
or outcome assessment. Descriptive information of each
intervention was extracted forqualitativepurposes.Four
reviewers conferred on each study to determine the relevant
outcome measures for the meta-analysis. The lead author
extracted data on total PA, MVPA, vigorous PA (VPA),
moderate PA (MPA), light PA and sedentary activity levels
Records eligible for meta-analysis (n=9)
Records identified through
searching electronic databases
(n=1804)
Records identified through other
reviews/references (n=217)
Records retained after removal of duplicates (n= 1605)
Records (abstracts) screened
(n=497)
Excluded (abstracts) (n=332)
Full text records reviewed
(n=165) Excluded (n=156)
Not conducted in US or on US children (n=73)
No sedentary outcome reported (n=24)
No objective measurement/accel (n=12)
Not a K-12 setting (n=12)
Not during school day hours (n=10)
Not an intervention (n=23)
Did not include 3-18 year old children (n=2)
Figure 1. Flow chart of selection process for sedentary time resulting in inclusion of nine unique records.
SEDENTARY TIME AND BEHAVIOR DURING SCHOOL 3
(e.g., minutes of MVPA, MET-weighted minutes of MVPA,
step counts, number of 30-min blocks/day, accelerometer
counts, change scores, adjusted odds ratios, and energy
expenditures). Data were extracted in the units reported.
Sedentary behaviors
At the conclusion of the full text search, there were no
studies that met the inclusion criteria.
Aggregation of data and statistical analysis
For all studies, estimates of time spent sedentary were
translated into percentage of wear time based on the
estimate of minutes spent sedentary and the reported
total wear time during a given segment of the
school day (i.e., total school day, PE, recess). The standard
deviation in percent for each study was calculated using
the coefficient of variation for each study. For each study,
the percent of time spent sedentary, sample size (n), and
standard deviation were used to create an inverse variance
sample-weighted estimate by weighting the contribution
of each study’s mean percent of time spent sedentary by
the sample size divided by the variance (i.e., square of the
standard deviation.
33
) Random effects models, account-
ing for the clustering of reported percentage of time spent
sedentary within studies (i.e., a single study could have
reported multiple age-sex values) were used to estimate
the average sample-weighted percentage of time spent
sedentary for all studies for boys and girls, separately.
Results
Descriptions of the sedentary time studies
Across the nine studies included, a total of 2,786 parti-
cipants across 64 schools (n= 51 elementary) partici-
pated. Four studies out of nine
24,27,31,34
were
Records eligible for meta-analysis (n=0)
Records retained after removal of duplicates (n=354)
Records (abstracts) screened
(n=280)
Excluded (abstracts) (n=124
)
Full text records reviewed
(n=156)
Excluded (n=156)
Not conducted in US or on US children (n=31)
No sedentary behaviors reported (n=42)
Not a K-12 setting or during school hours (n=82)
Published after February 2016 (n=1)
Records identified through
searching electronic
databases (n=1800)
Records identified through
other reviews references
(n=89)
Figure 2. Flow chart of selection process for sedentary behaviors resulting in inclusion of zero unique records.
4C. A. EGAN
intervention studies with 309 participants in eight mid-
dle schools
24
26 elementary schools,
24,27,34
2 pre-k-12
and 2 pre-k-8th schools.
31
The other five studies were
descriptive studies with 2,477 participants across 17
elementary schools
23,26,28–30
and one high school.
29
All
of the studies used accelerometers to measure PA levels.
Additionally, all of the studies focused on PA levels of
students, and time spent in sedentary was not a primary
outcome of any of the studies.
Six studies
23–26,28,29
focused on physical education. Of
those studies, only two focused exclusively on physical
education PA outcomes
28,29
(see Table 1). Three
studies
24,26,34
focused on physical education and recess
time PA. Gao et al.
23
focused on PA levels in physical
education and physical education using exer-gaming sys-
tems. Two studies
27,30
focused exclusively on PA levels
during recess time. Three studies
24,25,31
measured PA levels
during the whole school day with Carson
24
and Cradock
25
also reporting physical education and recess PA. None of
the studies reported sedentary time specific to time spent in
academic classrooms.
Results of the meta-analysis
The school day yielded the largest pooled estimate (63.1, SD
=3.1) of sedentary time. The least time spent sedentary was
during physical education (38.0, SD = 5.1). Pooled estimates
for other school contexts where sedentary time was mea-
sured included recess (44.7, SD = 1.8) and exergaming
(39.5, SD = 3.1). See Table 2.
Discussion
Based on the available data, U.S. youth spend, on average,
63% of their school day sedentary. These estimates exceed
the amounts of time children and adolescents spend seden-
tary after school.
15
Additionally, youth spend nearly half of
their time (44.7%) sedentary during recess and over a third
of their time (38%) sedentary during physical education.
Although these results are limited to only a handful of
studies, it is concerning that in certain cases children and
adolescents are spending such large quantities of time in
sedentary behavior within contexts generally thought to
offer the best chances for PA accumulation during school
hours. Combined with other reviews encompassing multi-
ple countries, including the U.S., which have shown youth
do not accumulate recommended amounts of time in
health-enhancing PA during physical education
35,36
or
recess,
37
this study underscores the need for interventions
to broaden their focus to include more comprehensive
programs and evaluations that target both PA promotion
and the reduction of sedentarism in school.
Studies in this review did not specifically measure
sedentary time in other school contexts, such as aca-
demic classrooms or lunch. As part of a whole-of-
school approach to promoting PA 1, these contexts
are considered key supporting environments beyond
physical education and recess to provide youth with
PA opportunities during school.
1
A whole-of-school
approach is a nationally recommended strategy for
combatting sedentary behaviors and offering students
Table 1. Characteristics of studies included for meta-analysis.
Title Outcome Measure
Sedentary
Time Reported Research Design PE Recess
Exer-
gaming School Day Primary Outcome
Carson et al.,
2014
18
Accelerometer
ActiGraph GT3X+/GT 1M
Minutes
per day
Quasi experimental
cluster control
design
X X X Differences in teacher
reported physical activity
offerings
Cradock et al.,
2014
19
Accelerometer:
ActiGraph GT3X/GT1M
Minutes
per day and
overall bouts
Quasi Experimental X X X Effectiveness of Active
School Day policy
implementation
Gao et al.,
2010
26
Pedometer Yamax Digi Walker
SW-701
Accelerometer Actical
% of time Descriptive X
Gao et al.,
2015
20
Accelerometer
ActiGraph GT3X
% of time Descriptive X X
Huberty et al.,
2014
21
Accelerometer
ActiGraph GT1M
% of time Ecological model-
based group
randomized trial
X The effectiveness of Ready
for Recess intervention on
staff training
Matthews-
Ewald et al,
2012
22
Accelermeter
ActiGraph GT3X
% of time Descriptive X
Matthews-
Ewald, 2014
23
Accelermoeter ActiGraph
GT1M and GTX3E
% of time Descriptive X
Ridgers et al.,
2011
24
Accelermeter
ActiGraph GT3X+/GT 1M
% of time Cross Sectional
Descriptive
X
Wells et al.,
2014
25
Accelerometer
ActiGraph GT3X+
% of time Longitudinal Cluster X Determine the effect of
gardens on children’s health
and healthy behaviors
SEDENTARY TIME AND BEHAVIOR DURING SCHOOL 5
maximum opportunities to accumulate PA in school
settings.
1
This approach targets all personnel in
a school setting that influence student behavior (e.g.,
administrators, teachers) and aims to increase PA
through multicomponent (e.g., physical education,
recess, academic classroom) and coordinated (e.g.,
involvement of all school staff) programming.
1
In the
present study, six of the nine studies targeted multiple
contexts as a way of measuring and/or reducing stu-
dents’sedentary time, including recess,
24–27,30
class-
room and during school PA,
24–26
school gardening,
31
and physical education.
23,26,28,29,34
Additionally, six of
the nine studies included recommendations for staff
training to decrease sedentary behaviors.
24,25,27–30
Future investigations should aim to measure sedentar-
ism is multiple contexts that map onto a whole-of-
school approach, as this will allow researchers to distill
periods of sedentary time across the school day and
target intervention efforts accordingly.
Overall, the limited number of studies that report
objectively measured sedentary time during school,
coupled with the absence of studies that provide any
information on the kinds of sedentary behaviors youth
engage in during these hours, suggests that further
descriptive research is needed to guide the work of inter-
ventionists and establish guidelines for limiting school-
based sedentarism. Measuring different types of sedentary
behavior is not only important in terms of tailoring inter-
vention work to address specific kinds of school activities
but also in terms of determining which behaviors may
have the most deleterious consequences (e.g., health, aca-
demic performance) for children and adolescents.
A growing body of evidence suggests that some kinds of
sedentary behaviors may have more negative effects than
other kinds of sedentary behaviors, and that such effects
may vary depending on age,
38
gender, and socioeconomic
factors.
39
Translation to Health Education Practice
Whole-of-school approaches for reducing sedentary
time and increasing PA are built on ecological frame-
works (i.e., understanding the influences on PA in
schools)
40
and align with broader public health recom-
mendations for examining sedentarism.
5,39
In school
settings, it is suggested that environmental changes be
Table 2. Studies included for meta-analysis, mean, standard deviation, variance, confidence interval, z and pvalues.
Group Study Subgroup Mean SD Var. Lower 95 CI Upper 95 CI z-value p-value
Physical Education Only Gao 2010
26
PE 8.9 0.2 0.0 8.4 9.3 41.8 0.000
Gao 2015
20
Grade 1 PE 15.0 0.5 0.3 14.0 16.0 29.1 0.000
Gao 2015
20
Grade 2 PE 15.0 0.6 0.3 13.9 16.1 27.1 0.000
Matthews-Ewald 2012
22
Class Content-Knowledge 52.7 3.8 14.5 45.2 60.2 13.9 0.000
Matthews-Ewald 2012
22
Gender- Female 45.3 1.3 1.7 42.7 47.9 34.4 0.000
Matthews-Ewald 2012
22
Gender-Male 43.0 1.3 1.7 40.4 45.6 32.9 0.000
Matthews-Ewald 2012
22
Grade-2nd Grade 42.1 1.3 1.6 39.6 44.6 33.6 0.000
Matthews-Ewald 2012
22
Grade-5th Grade 46.8 1.4 1.9 44.1 49.5 34.0 0.000
Mathews-Ewald 2012
22
Class Content-Motor Skills 43.8 1.1 1.1 41.7 45.9 41.2 0.000
Matthews-Ewald 2014
23
Elementary 36.7 0.8 0.6 35.2 38.2 46.6 0.000
Matthews-Ewald 2014
23
High School 70.0 1.6 2.6 66.8 73.2 43.2 0.000
Random 38.0 5.1 26.3 28.0 48.1 7.4 0.000
Exergaming Only Gao 2015
20
Grade 1 Exergamming 55.0 1.9 3.6 51.3 58.7 29.1 0.000
Gao 2015
20
Grade 2 Exergamming 24.0 0.9 0.8 22.3 25.7 27.1 0.000
Random 39.5 15.5 240.2 9.1 69.8 2.5 0.011
Recess Only Gao 2015
20
Grade 1 Recess 49.0 1.7 2.8 45.7 52.3 29.1 0.000
Gao 2015
20
Grade2 Recess 63.0 2.3 5.4 58.4 67.6 27.1 0.000
Huberty 2014
21
Boys Baseline -Control 43.0 1.4 2.1 40.2 45.8 29.9 0.000
Huberty 2014
21
Boys Baseline-Equipment 49.4 1.5 2.4 46.4 52.4 31.9 0.000
Huberty 2014
21
Boys Baseline-Equipment and Staff 37.7 1.4 2.0 34.9 40.5 26.7 0.000
Huberty 2014
21
Boys Baseline-Staff 37.4 2.1 4.4 33.3 41.5 17.7 0.000
Huberty 2014
21
Girls Baseline -Control 47.8 1.4 1.9 45.1 50.5 34.3 0.000
Huberty 2014
21
Girls Baseline-Equipment 49.9 1.7 2.7 46.7 53.1 30.2 0.000
Huberty 2014
21
Girls Baseline-Equipment and Staff 50.7 1.2 1.4 48.4 53.0 43.3 0.000
Huberty 2014
21
Girls Baseline-Staff 45.2 2.0 3.9 41.3 49.1 22.9 0.000
Ridgers 2011
24
Boys-Grade 3 30.9 1.8 3.4 27.3 34.5 16.8 0.000
Ridgers 2011
24
Boys- Grade 6 36.4 2.3 5.3 31.9 40.9 15.8 0.000
Ridgers 2011
24
Boys-Grade 4 43.9 3.0 9.0 38.0 49.8 14.7 0.000
Random 44.7 1.8 3.3 41.1 48.2 24.6 0.000
School Only Carson 2014
18
Boys Control 72.3 1.4 2.0 69.5 75.0 51.1 0.000
Carson 2014
18
Boys Intervention 69.2 1.5 2.3 66.2 72.1 45.6 0.000
Carson 2014
18
Girls Control 73.3 0.9 0.8 71.5 75.1 79.9 0.000
Carson 2014
18
Girls Intervention 69.9 0.9 0.8 68.1 71.7 77.0 0.000
Cradock 2014
19
Control- Baseline 54.3 2.2 4.9 50.0 58.7 24.5 0.000
Cradock 2014
19
Intervention- Baseline 55.2 2.2 4.6 51.0 59.4 25.6 0.000
Wells 2014
25
Control- Pre 54.8 1.3 1.7 52.2 57.3 42.3 0.000
Wells 2014
25
Control-Pre 55.2 1.3 1.7 52.7 57.8 42.9 0.000
Random 63.1 3.1 9.3 57.1 69.1 20.7 0.000
6C. A. EGAN
made to reduce sitting time (e.g., sit to stand desks) in
tandem with teacher training to reduce sedentary
bouts.
5
Professional development for classroom tea-
chers and School Health Educators should include
ideas about how to incorporate movement breaks, inte-
grate PA into instruction and learning, use managerial
strategies that promote naturally occurring PA in their
classrooms (e.g., use routines and incentives/rewards
that allow for frequent movement opportunities),
41
and stimulate PA at recess by using playground mark-
ings, activity zones, portable equipment, active super-
vision, and low-organized games.
42
School Health
Educators and Physical education teachers should be
provided professional learning opportunities that focus
on effectively teaching toward subject matter standards
while keeping students active during lessons. Trainings
must also be designed to include principals, counselors,
and other school staff, who can help to coordinate
school wide efforts to reduce sedentarism. Evaluations
of these types of interventions and their effects on both
sedentary time and behavior are warranted.
Furthermore, in order to better understand influences
on sedentary time in schools, rigorous quantitative (e.g.,
prospective, longitudinal, experimental) studies that ana-
lyze the determinants of sedentary behavior
5
alongside the
reporting of segmented school day sedentary time and
behaviors are needed. Qualitative investigations must also
be pursued to provide depth of understanding about factors
(e.g., environmental, sociological, psychological) that influ-
ence sedentarism in school.
4
School Health Educators
andPAinterventionistsinschoolsshouldbepresenting
their data relating to sedentary behaviors, sedentary bouts,
and total time spent sedentary. Without this crucial infor-
mation, it is impossible to identify how interventions
impact school-based sedentarism and what should be
done in the future to reduce it.
Acknowledgment
There are no acknowledgments the authors wish to make.
Disclosure statement
No potential conflict of interest was reported by the authors.
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