A Systematic Review of Policies Promoting Physical Activity in Children and Adolescents Worldwide

Abstract

Context: Given the importance of physical activity for the health of children and adolescents, and considering the role of policies as determinants of individual behavior, timely updates and revisions of these policies are essential. The present study aims to identify the common dimensions of policies promoting physical activity among children and adolescents worldwide. Evidence Acquisition: This systematic review was conducted in accordance with PRISMA guidelines. A comprehensive search was performed across major databases, including Science Direct, PubMed, Web of Science, and ProQuest, as well as the scholarly search engine Google Scholar, covering literature up to March 2025. The search utilized the keywords "Physical Activity", "Sedentary Behavior", "Policy", "Child", and "Adolescent". Data were collected using a data extraction table and then analyzed using Braun and Clarke’s thematic analysis method. The "Mixed Methods Appraisal Tool" (MMAT) was used to evaluate the quality of the articles. Results: A total of 19 studies out of 13,842 identified were deemed eligible. Fourteen studies (74%) examined policies related to physical activity during the school day, one (5%) focused on policies before and after school, one (5%) addressed policies integrating physical activity, sleep, and sedentary behavior over a 24-hour period, and one (5%) investigated financial incentive schemes aimed at increasing physical activity. Except for one, all studies focused on in-school and before- and after-school environments. Five common dimensions were identified: Governance and policymaking, educational institutions (schools), collaboration and participation of sports organizations, education and awareness, and transportation and urban planning. The quality of the studies was evaluated as good. Conclusions: This review demonstrated that policy interventions, such as financial incentives, infrastructure improvements, mandatory school policies, active urban planning, family engagement, and the use of smartphone-based technologies, enhance children’s and adolescents’ participation in physical activity. To achieve this goal, it is recommended to focus on comprehensive strategies, policy localization, and intersectoral collaboration. Additionally, future studies should explore implementation barriers and the role of intersectoral cooperation.