Ci a ion: Bailey, R.; Ries, F.; Scheue ,
C. Ac i e Schools in Eu ope—A
Re iew o Empi ical Findings.
Sus ainabili y 2023,15, 3806.
h ps://doi.o g/10.3390/
su15043806
Academic Edi o : Giuseppe
Ba aglia
Recei ed: 13 No embe 2022
Re ised: 19 Janua y 2023
Accep ed: 1 Feb ua y 2023
Published: 20 Feb ua y 2023
Copy igh : © 2023 by he au ho s.
Licensee MDPI, Basel, Swi ze land.
This a icle is an open access a icle
dis ibu ed unde he e ms and
condi ions o he C ea i e Commons
A ibu ion (CC BY) license (h ps://
c ea i ecommons.o g/licenses/by/
4.0/).
sus ainabili y
Re iew
Ac i e Schools in Eu ope—A Re iew o Empi ical Findings
Richa d Bailey 1,2 , F ancis Ries 3and Claude Scheue 4,*
1Facul y o Social Sciences and Libe al A s, UCSI Uni e si y, Jalan Mena a Gading, Che as,
Kuala Lumpu 56000, Malaysia
2Cen e o Resea ch o Men al Heal h and Wellbeing, UCSI Uni e si y, Jalan Mena a Gading, Che as,
Kuala Lumpu 56000, Malaysia
3Physical Educa ion and Spo s, Facul y o Educa ional Sciences, Uni e si y o Se ille, 41013 Se illa, Spain
4Eu opean Physical Educa ion Associa ion, 8551 Noe dange, Luxembou g
*Co espondence: [email p o ec ed]
Abs ac :
Physical ac i i y is an impo an pa o child en’s and young people’s heal hy unc ioning,
bu e idence sugges s many s uden s a e inac i e o he ex en ha hey a e comp omising hei
well-being. T adi ionally, schools ha e played a mino ole in con ibu ing o physical ac i i y, bu i
has held ela i ely low p es ige. Some commen a o s ha e called o Whole-School o Ac i e School
app oaches. Physical ac i i y, in hese models, is in eg a ed in o all aspec s o school li e. This a icle
epo s on a e iew o he mos -ci ed elemen s o school-based physical ac i i y p omo ion, assesses
e idence o ac ual and po en ial con ibu ions, and p o ides a en a i e weigh o e idence judgemen
o each componen . A apid e iewing me hodology was ollowed, and he sea ches used a ange
o specialis academic da abases (PsycARTICLES, PsycINFO, SPORTdiscus, CINAHL Comple e),
Google Schola , Resea chGa e, and Academia.edu, es ic ed o 2010–2021. Six se ings we e ound o
ha e he po en ial o add physical ac i i y ime, al hough none su ices alone: Ac i e B eaks; Ac i e
Homewo k; Ac i e Lea ning; Ac i e Recess; Ac i e T anspo ; and School Spo s. Ac i e Schools
o e a plausible solu ion o he p oblem o physical inac i i y by adding momen s o mo emen and
in eg a ing physical ac i i y in all aspec s o school li e, unde lining he need o school-le el change,
he conside a ion o s akeholde g oups, and he social and physical en i onmen s o school.
Keywo ds:
ac i e b eaks; ac i e class ooms; ac i e homewo k; ac i e ecess; ac i e a el; adolescen s;
child en; physical ac i i y; physical educa ion; school spo s
1. In oduc ion
Schools a e expec ed o ul il many di e en oles, bu mos would p obably ag ee ha
wo ambi ions a e cen al: he de elopmen o s uden s’ well-being and he knowledge,
skills, a i udes, and alues likely o encou age a happy and success ul li e [
1
]. Cu iculum
con en has de eloped o suppo he cons i u i e elemen s o hese ambi ions. Among
hem, physical educa ion (PE), spo s, and o he o ms o physical ac i i y (PA) ha e been
ec ui ed o play a ole. T adi ionally, howe e , hese ac i i ies ha e held ela i ely low
p es ige, o en jus i ied as a b eak om he eal business o schooling, namely academic
wo k [
2
]. This si ua ion changed signi ican ly in ecen yea s as alling le els o PA ha e led
in e na ional agencies, na ional go e nmen s, and agencies o sound calls o ala m abou
ising inciden s o non-communicable diseases, such as Type 2 diabe es, hea disease, and
obesi y [
3
]. Due o si ing beha io es ablished a school, child en and adolescen s a e also
inc easingly expe iencing musculoskele al diso de s [4].
Despi e he ac ha egula PA is nea -uni e sally acknowledged o be an impo an
pa o child en’s and young people’s heal hy unc ioning, he e is compelling and ala ming
e idence ha la ge numbe s o you h a e inac i e o he ex en ha hey a e comp omising
hei well-being, bo h now and in la e li e [
5
]. Obese child en and adolescen s a e a ound
i e imes mo e likely o be obese in adul hood [
6
]. Globally, 50% o child en do no mee he
Sus ainabili y 2023,15, 3806. h ps://doi.o g/10.3390/su15043806 h ps://www.mdpi.com/jou nal/sus ainabili y
Sus ainabili y 2023,15, 3806 2 o 22
in e na ionally ecognized a ge o 60 min mode a e- o- igo ous physical ac i i y (MVPA)
pe day [
7
,
8
]. This igu e ises o 80% in highe -income coun ies [
8
] and pe sis s in o
adolescence [
9
]. As he g ea majo i y o child en ha e exposu e o school, i is unsu p ising
ha Eu opean policies p omo e whole-school app oaches as one o he mos p omising
in es men s o childhood and you h PA [
4
]. Indeed, o a g owing numbe o child en,
schools p o ide he main oppo uni y o egula , s uc u ed spo s and PA. A combina ion
o economic p essu es and pa en al sa e y conce ns means ewe child en can play games
in non-school se ings [
10
]. The e o e, schools’ unique socie al posi ion has led o calls ha
hey engage wi h public heal h issues, o example PA, mo e ully.
Clea ly, he adi ional aming o PA in school—p ima ily h ough PE lessons and,
less o en, school spo s—will no su ice o mee his challenge. PE alone a ely occupies
enough cu iculum space o p o ide enough equency, in ensi y, and du a ion o PA
o acc ue heal h bene i s [
11
,
12
], and olun a y spo s clubs o en s uggle o include
p ecisely he s uden s who need PA he mos [
13
]. Many commen a o s ha e called
o mo e comp ehensi e, whole-school, o Ac i e School app oaches [
4
,
14
–
16
]. In hese
app oaches, PA is no longe isola ed o PE o clubs, no is i he sole esponsibili y o PE
eache s [
17
]. I has also become clea ha , along wi h inc easing PA, schools’ lea ning and
li ing en i onmen s mus change. Ac i e School concep s conside he whole sys em and
a e “cause o ien ed” [
4
]. Some commen a o s ha e concep ualized school en i onmen s as
complex adap i e subsys em [
18
] cha ac e ized by dynamic ne wo ks o in e ac ions ha
p oduce eme gen e ec s g ea e han he sum o he componen s [
19
]. The de elopmen
and applica ion o knowledge in his eme gen ield ha e been slowed by i s inhe en
heo e ical complexi y and he limi ed knowledge o he exis ing e idence ela ed o i s
componen s. This pape can be unde s ood as a con ibu ion o his second conce n. I
p esen s an o e a ching e iew o he mos -ci ed elemen s o school-based PA in e en ions
and p ac ices, assesses e idence o ac ual and po en ial con ibu ions o s uden s’ heal h-
enhancing PA, and p o ides a en a i e weigh o e idence judgmen o each componen .
This is he i s holis ic e iew o he ou comes associa ed wi h Ac i e Schools. This
app oach seems app op ia e as he Ac i e Schools concep posi s a syne gis ic e ec in
which disc e e elemen s in e ac o c ea e a school-wide impac . In o he wo ds, Ac i e
Schools inhe en ly in ol e comp ehensi e o e sigh . This a icle concludes by e alua ing
he ex en o which he no ion o Ac i e Schools migh o e a p ac ical, sus ainable solu ion
o he global challenges o child en’s and young people’s well-being due o inac i i y and
seden a y li es yles.
2. Me hods
E idence o hese e iews was ga he ed using a apid e iewing me hodology. Rapid
e iewing has become an inc easingly popula o m o e idence syn hesis in which compo-
nen s o he sys ema ic e iew p ocess a e simpli ied o omi ed o p oduce in o ma ion
mo e quickly and/o o a mo e a iega ed esponse [
20
]. The mul i ace ed na u e o
he p esen s udy mean ha a sys ema ic e iew was no a iable op ion. Howe e , he
au ho s’ hope was o ealize some o he i ues o sys ema ic e iewing wi hou becom-
ing o e come by i s inhe en es ic ions. Sea ches used a ange o specialis academic
da abases (PsycARTICLES, PsycINFO, SPORTdiscus, CINAHL Comple e), Google Schola ,
Resea chGa e, and Academia.edu. The a ionale o including he mo e gene al sou ces
(Schola , e c.) was pa ly a hope ha hey migh gene a e indings ha ha e been missed by
he academic da abases ( his u ned ou no o be he case) and pa ly because hey con ain
ele an esea ch-o ien a ed ma e ials p oduced ou side o adi ional scien i ic publishing
( he so-called ‘g ey li e a u e’), which would be use ul o in o ming he con ex o his
s udy. Recommenda ions we e made by membe s o he HEPAS (Heal hy and Physically
Ac i e Schools in Eu ope) p ojec eam (see Acknowledgemen s o u he de ails), who
we e sen a penul ima e d a o he epo and essen ially ac ed as in e nal e iewe s. The
ollowing c i e ia we e used o keep sea ches ocused:
Sus ainabili y 2023,15, 3806 3 o 22
•Published om 1 Janua y 2010 o 30 May 2021;
•
S udy sample is made up wholly o mainly o school-aged child en wi hin he ange
o Eu opean na ions (4-yea s-old o 17-yea s-old);
•S udy conduc ed in ei he p ima y o seconda y schools;
•S udy in es iga ed PA ou comes ei he as he sole o subs an ial ocus;
•Empi ical s udy o sys ema ic e iew;
•Empi ical s udies based subs an ially o wholly in Eu ope.
These c i e ia we e used o guide he ec ui men o he mos ele an s udies. Follow-
ing some ea lie apid e iews, we did no ollow sea ch s a egies ha igo ously excluded
po en ial sou ces (such as PRISMA) bu elied on he s udy’s aims and he exclusion c i e ia
o in o m judgmen s abou ele ance. Ini ial sea ches we e conduc ed in English, ollowed
by Ge man, F ench, Spanish, and Czech. The sea ch used b oad MeSH e ms (Medical Sub-
jec Headings) o cap u e he mos cu en s udies and e iews. Fo example, “ ecess” AND
“physical ac i i y” AND “child en”. Da a on each con ex o in e es we e ex ac ed, and
he indings we e alida ed wi h e e ence o o he ga he ed da a and published e iews.
These da a-se s we e hen used as he sou ces o he c ea ion o he na a i e commen a ies
ha appea la e in his a icle. This app oach was selec ed as mos app op ia e o e lec
he a iega ed se ings and he impe a i e o in e p e indings in p ac ically o ien a ed
ways. The e iews we e limi ed by a ocus on school-se ing and school-aged child en and
young people.
The gene al app oach ollowed an ea lie se o PA e iews by Public Heal h
England [
21
]. As such, i in ol ed a pu posi e sea ch, in eg a ion, and ansla ion o
ele an li e a u e ela ed o con ex s o Ac i e Schools. Once he di e en e iews had
been comple ed, a g oup o expe s (see Acknowledgemen s) independen ly e alua ed he
weigh o e idence pe aining o he indings o each ac i i y se ing. Disc epancies we e
discussed, and a consensus was ag eed upon o each a ea.
3. Resul s
3.1. Physical Ac i i y Se ings a School
As o he se ing Physical Ac i i y, 14 ele an sys ema ic e iews we e iden i ied:
i e o Ac i e B eaks, one o Ac i e Lea ning, six o Ac i e Recess and wo o Ac i e
T anspo (Table 1).
Table 1. Physical Ac i i y Se ings a School—Sys ema ic Re iews.
A ea Sou ce Coun ies o
Au ho s Type o Re iew Age Phase Sample Key Findings
Ac i e B eaks
Daly-Smi h,
Zwolinsky,
McKenna, e al.
(2018)
UK/US Sys ema ic
e iew 4–17 yea olds
Inclusion c i e ia
we e ocused on
school-based bou s
o class oom
mo emen b eaks
wi h 4–17 yea olds.
Sea ches o eigh
scien i ic da abases
( o July 2017)
Th ee s udies
assessed PA.
In e en ions
eplaced seden a y
ime wi h ei he LPA
o MVPA depending
on design
cha ac e is ics
(mode, du a ion,
in ensi y).
Class oom
mo emen b eak
inc eased PA
Sus ainabili y 2023,15, 3806 4 o 22
Table 1. Con .
A ea Sou ce Coun ies o
Au ho s Type o Re iew Age Phase Sample Key Findings
Ac i e B eaks
E win, Fedewa,
Beighle, e al.
(2012)
US Sys ema ic
e iew
Sea ches o i e
scien i ic da abase,
plus cascading
using e e ences in
included s udies.
The ange was Jan
1990–Feb ua y 2010.
six s udies measu ed
e ec s o Ac i e
B eaks on PA. B eaks
inc eased amoun o
PA in each school
day. P ima y school
s uden s a ec ed
mos by
in e en ions.
In e en ion leng h
did no signi ican ly
in luence
in e en ion e ec .
Ac i e B eaks Masini, Ma ini,
Go i, e al. (2020)
I aly Sys ema ic
e iew
Sea ches o six
da abases and g ey
li e a u e, wi h no
ime es ic ion and
up o Ap il 2019.
Twen y- wo
in e en ion s udies
we e ound. Ac i e
B eaks in e en ions
had a signi ican
e ec in inc easing
bo h MVPA and s ep
coun in p ima y
school child en.
Ac i e B eaks
No is, an
S een,
Di ei o, e al.
(2019)
UK,
Ne he lands,
Singapo e,
Aus alia
Me a- analysis
Six sea ches o six
da abases and g ey
li e a u e; no ime
es ic ion up o
Ap il 2019.
Re e ence cascading
in included s udies.
Fo y- wo s udies
( hi y-nine
p eschool o
elemen a y)
iden i ied. Ac i e
lessons p oduced
signi ican inc eases
in lesson- ime PA,
small inc eases on
o e all PA.
Ac i e B eaks
Wa son,
Timpe io,
B own, e al.
(2017)
Aus alia Sys ema ic
e iew
5–12
yea s o age
Sea ches o ou
da abases and g ey
li e a u e up o
Janua y 2017 we e
ca ied ou .
Thi y-nine s udies
me he inclusion
c i e ia, and six een
p o ided su icien
da a and app op ia e
design o inclusion
in he me a-analyses.
Resul s o
me a-analyses
showed no e ec
o PA.
Ac i e Lea ning
No is, Shel on,
Dunsmui , e al.
(2015)
UK (England)
and Aus alia
Sys ema ic
e iew
Any age g oup
o school
s uden s
Ele en s udies we e
iden i ied: i e
examined PA
ou comes only;
h ee examined
educa ional
ou comes only; and
h ee examined
bo h PA and
educa ional
ou comes.
All s udies ound
imp o ed PA
ollowing ac i e
lessons: ei he in he
whole in e en ion
g oup o speci ic
demog aphics.
Educa ional
ou comes ei he
signi ican ly
imp o ed o no
di e en .
Sus ainabili y 2023,15, 3806 5 o 22
Table 1. Con .
A ea Sou ce Coun ies o
Au ho s Type o Re iew Age Phase Sample Key Findings
Ac i e Recess
B oekhuizen,
Schol en and De
V ies (2014)
Ne he lands Sys ema ic
e iew
2–18
yea s old
Thi een
expe imen al and
se en een
obse a ional
s udies
Expe imen al s udies
gene a ed mode a e
e ec s a e he
p o ision o play
equipmen ,
inconclusi e
e idence o use o
playg ound
ma kings, alloca ing
play space and
mul i-componen
in e en ions. No
e idence o
inc easing ecess
du a ion on heal h.
Obse a ional
s udies showed
posi i e associa ions
be ween equipmen
and PA le el.
Signi ican
associa ions ound
be ween PA and
dec eased
playg ound densi y
and inc eased ecess
du a ion. densi y,
he p omo ion o PA
by s a .
Ac i e Recess
Escalan e,
Ga cía-
He moso,
Backx, e al.
(2014)
Spain and UK
(Wales)
Sys ema ic
e iew 2–12 yea s
Eigh a icles me
he inclusion
c i e ia
The s a egies had
po en ial o inc ease
PA du ing ecess.
Cumula i e e idence
was (i) in e en ions
based on playg ound
ma kings, game
equipmen , o a
combina ion o he
wo, do no inc ease
child en’s PA du ing
ecess;
(ii) in e en ions
based on playg ound
ma kings plus
physical s uc u es
inc ease he PA o
schoolchild en
du ing ecess in he
sho o
medium e m.
Ac i e Recess Ickes, E win and
Beighle (2013) US Sys ema ic
e iew
P eschools and
elemen-
a y/p ima y
schools
Thi een
in e en ions
ep esen ed bo h
se ings wi hin he
U.S and
in e na ionally
S a egies included:
added equip-
men /ma e ials,
ma kings, zones,
eache in ol emen ,
ac i e ideo games,
ac i i y o he week,
and ac i i y ca ds.
O included s udies,
95% demons a ed
posi i e ou comes as
a esul o he ecess
in e en ion.

Sus ainabili y 2023,15, 3806 6 o 22
Table 1. Con .
A ea Sou ce Coun ies o
Au ho s Type o Re iew Age Phase Sample Key Findings
Ac i e Recess
Pa ish, Okely,
S anley, e al.
(2013)
Aus alia Sys ema ic
e iew 5–18 yea s
Nine a icles me
he inclusion
c i e ia
Inconclusi e
indings o all
in e en ion ypes.
Fi e s udies
demons a ed
posi i e in e en ion
e ec s on PA le els,
wi h ou epo ing
s a is ically
signi ican inc eases
and wo epo ing
signi ican dec eases
in ecess PA.
Ac i e Recess
Reilly, Johns on,
McIn osh, e al.
(2016)
UK (Sco land) Sys ema ic
e iew
P ima y and
high school
child en
Twen y- ou
eligible s udies o
p ima y school
s uden s; wo
eligible s udies o
high school
s uden s.
Recess made a small
con ibu ion o daily
MVPA. Subs an ial
policy e o is likely
o be needed i ecess
is o make a mo e
use ul con ibu ion
o MVPA among
child en and
adolescen s.
Ac i e Recess
Ridge s, Salmon,
Pa ish, e al.
(2012)
Aus alia Sys ema ic
e iew 5–18 yea s Fi y- h ee s udies
Posi i e associa ions
we e ound be ween
o e all acili y
p o ision, un ixed
equipmen , and
pe cei ed
encou agemen and
ecess PA. Resul s
e ealed boys we e
mo e ac i e
han gi ls.
Ac i e T anspo
La ouche,
Saunde s,
Faulkne , e al.,
2014
Canada Sys ema ic
e iew
5.0 o 17.9
yea s old Six y-eigh s udies
Ac i e T anspo
use s we e mo e
ac i e inac i e pee s
and in e en ions
lead o inc eases in
PA. All s udies wi h
ele an measu es
ound a posi i e
associa ion be ween
cycling o/ om
school and i ness.
Ac i e T anspo
Ma in, Kelly,
Boyle, e al.
(2016)
UK (Sco land)
Sys ema ic
e iew and me a-
analysis
P ima y and
Seconda y aged
s uden s
Twel e s udies
17 min pe day
MVPA accumula ed
walking o/ om
school in p ima y
pupils; 13 min in
high school pupils.
Walking o/ om
school con ibu ed
23% and 36% o
MVPA on
schooldays in
p ima y school age
child en and high
school pupils,
espec i ely.
Sus ainabili y 2023,15, 3806 7 o 22
3.1.1. Ac i e B eaks
Ac i e B eaks a e sho du a ion ( ypically 5–15 min) sessions o PA, usually led by
class eache s o o he membe s o school pe sonnel, du ing class oom-based lessons. Ac-
i e B eaks can ake a ious o ms, and many cu icula ha e been de eloped, es ed, and
dissemina ed, i.e., [
22
]. Teache s end o combine p e-p oduced and sel -de eloped ac i i-
ies. Some ac i e b eak s a egies in ol e s opping ins uc ion o se e al minu es, asking
s uden s o s and o mo e elsewhe e in he class oom, o ha ing he eache o a ideo
lead a guided ac i i y ha in ol es mo emen . These ac i i ies’ du a ion, in ensi y, and
s uc u e can a y conside ably [
23
]. Ac i e B eaks a e unusual wi hin he PA oppo uni ies
discussed in his epo , as hei implemen a ion depends on decisions made by class oom
eache s. Many class oom eache s do no ha e expe ience implemen ing Ac i e B eaks,
and he limi ed e idence indica es hey a e no widely used in p ima y school class ooms
and ba ely in seconda y schools [23].
Fi e sys ema ic e iews o me a-analyses o Ac i e B eaks me he inclusion
c i e ia [
18
,
24
–
27
]. These e iews suppo he claim ha Ac i e B eaks inc ease child en’s
PA le els. Howe e , a ela i ely high numbe o s udies e iewed we e o low me hod-
ological quali y. Excep o he I ish p og am de ised as pa o Mu agh, Mul ihill, and
Ma key [
28
], exis ing p og ams ha e ended o ha e aken place in he US. The e o e,
indings om hese e iews should be in e p e ed wi h cau ion.
Se e al PA in e en ions ha e iden i ied ac o s ha media e success ul Ac i e B eaks
in e en ions, such as ime, esou ce a ailabili y, and a suppo i e school clima e migh a -
ec implemen a ion [
29
]. Schools a e also unde pe o mance p essu e o achie e academic
objec i es, which o en educes PE ime and PA oppo uni ies [
30
]. The e o e, a success ul
school-based PA scheme should be in eg a ed in o he cu iculum and he school day.
The Ac i e B eaks discussed in he s udies o his e iew a ied in du a ion om
4 min o 20 min. Ac i i ies ended o ocus on ae obic exe cise (e.g., ma ching wi h
a m mo emen s, jogging, unning, jumping, and hopping). The e a e nume ous ways o
applying Ac i e B eaks in class ooms, such as using p e-packaged p og ams, ideo exe cise
guides, and/o c ea ing and implemen ing hei own s a egies. P e iously e alua ed
p og ams ha ha e in eg a ed Ac i e B eaks ound ha hey can p omo e PA, inc ease
ime on asks and imp o e academic pe o mance. E idence sugges s ha well-designed
ac i e b eak p og ams can signi ican ly impac child en’s PA. Fo example, one case s udy
showed he inco po a ion o s uc u ed Ac i e B eaks inc eased MVPA o p eschoole s,
accoun ing o 60–90% o ime spen in MVPA a school [
31
]. Ano he s udy p o ided
s ong e idence ha he Take 10! P og am inc eased PA le els in child en om 5–10 yea s
old, in a ious con ex s, in di e en coun ies. The e iew o empi ical esea ch based on
he scheme epo ed a leas a 13% inc ease in PA le els [32].
As wi h PA, in gene al, gi ls end o be less ac i e du ing Ac i e B eaks han boys [
33
].
Gi ls spend less ime in ligh PA (LPA) and MVPA and a e mo e inac i e han boys.
Howe e , possibly due o hei lowe baseline sco es, gi ls espond be e o ac i e b eak
in e en ions [
33
]. In addi ion, gende di e ences ha e been epo ed in deli e y me hod-
ologies, wi h gi ls esponding be e o educa ional componen s based on social lea ning
heo y, while boys may be mo e in luenced by s uc u al and en i onmen al changes
acili a ing inc eased PA [34].
Teache s a e c i ical in implemen ing success ul p og ams by demons a ing, mo i a -
ing, and moni o ing PA sessions [
33
]. Ac i e B eaks can add ess he lack o some eache s’
knowledge and suppo he posi i e ole ha ac i i y plays in he lea ning en i onmen .
Empi ical s udies sugges Ac i e B eaks a e gene ally popula wi h bo h s uden s and
eache s. No e idence has been ound ha hey necessa ily in e e ed wi h class oom
lea ning o a ec ed s uden beha io de imen ally [
32
,
35
]. Teache s end o p e e Ac i e
B eaks o ela i ely low in ensi y, seeing VPA Ac i e B eaks as dis up i e o hei each-
ing [
36
], which is un o una e as VPA is mo e bene icial in e ms o bo h physical heal h and
academic e ec s [
37
]. Some e idence sugges s ha equen , sho MVPA Ac i e B eaks
o e a easible al e na i e o VPA b eaks, leading o posi i e ou comes [38].
Sus ainabili y 2023,15, 3806 8 o 22
O e all, he e idence demons a es ha Ac i e B eaks inc ease s uden s’ PA le els.
O he epo ed bene i s include heal hie weigh s a us, imp o ed beha io , enhanced
cogni ion, and g ea e enjoymen . As wi h o he aspec s o PA ou comes, he success ul
implemen a ion o Ac i e B eaks seems o depend on se e al con ex ual ac o s, including:
•A ailabili y o ele an esou ces;
•Teache and senio managemen suppo ;
•Posi i e eache a i udes [39].
A wo d o cau ion should be sounded, oo. Many o he published s udies on Ac i e
B eaks a e o ela i ely low quali y, and he e is high a iabili y in impo an design ea u es,
in e en ion me hods, du a ion and in ensi y, and ou come measu es. The e o e, u he
wo k in his a ea is needed. Ne e heless, Ac i e B eaks seem a po en ially aluable sou ce
o PA ha enhances, a he han in e e es wi h, wide educa ional ou comes.
3.1.2. Ac i e Homewo k
Ac i e Homewo k has been p oposed as a possible way o p omo ing PA among
s uden s by ex ending he ime a ailable o schools o in luence s uden s’ heal h beha -
io s [
40
]. Homewo k ac i i ies can be designed o s uden s o apply and p ac ice he skills
lea ned in PE lessons and migh ake place a home (wi h o wi hou pa en s’ in ol emen )
and in nea by spo ing en i onmen s o acili ies [
41
]. Acco ding o Kääpä, Palomäki,
Vähä-Ypyä, e al. [
40
], s uden s can ind homewo k connec ed o PE lessons enjoyable and
bene icial. Fo example, s uden s epo ed posi i e esponses o homewo k ha included
p ac icing wi h amily membe s. In addi ion, i has been ound ha Finnish s uden s enjoy
pa icipa ing in planning PE homewo k [
40
]. One pa o he a ionale o Ac i e Homewo k
is o encou age s uden s o become amilia wi h hei local en i onmen s and a ailable
acili ies o help make PA pa o hei li es yles [42].
The e idence base ega ding Ac i e Homewo k is limi ed. Only one sho e iew o
he li e a u e has been ca ied ou in his a ea [
43
], which included no ele an s udies o
his epo . Th ee empi ical s udies we e iden i ied ha examined he ela ionship be ween
Ac i e Homewo k and PA [
44
,
45
], bu only one was based in Eu ope. The sole Eu opean
s udy was conce ned wi h Finnish adolescen gi ls in a jou nal o ques ionable quali y and
wi h nei he con ols no p e–pos measu es [
40
]. Ac i e Homewo k ep esen ed a small pa
o he s uden s’ whole-day PA, a e aging 34 min pe week. In o al, 38% o he gi ls me he
ecommended le els o PA, which, in ligh o he mean PA esul s, implies ha a subs an ial
numbe o gi ls engaged in minimal PA (al hough his is no men ioned in he ex ), so he
e idence base ela ed o Ac i e Homewo k is cu en ly weak. I does seem a plausible s a egy,
bu wi hou c edible esea ch indings, he case o Ac i e Homewo k is unp o en.
3.1.3. Ac i e Lea ning
The use o PA in a c oss-cu icula se ing a ies conside ably. In some coun ies,
PA s ands ela i ely sepa a e om o he aspec s o schooling, while in o he s, cu iculum
guidance makes he expec a ion o in eg a ion wi h o he a eas clea [
46
]. Many eache s
epo inding i di icul o win suppo o adding PA o he school day om colleagues
and manage s [
36
], and ime cons ain s a e o en signi ican ba ie s o implemen ing
new PA [
47
], o en due o cu iculum demands in key lea ning a eas and associa ed
academic accoun abili y p essu e [
48
]. The e o e, ime-e icien PA p omo ion s a egies
ha con ibu e o PA p omo ion wi hou unde mining academic achie emen a e aluable.
Ac i e Lea ning has been p oposed as a plausible solu ion o his challenge.
The e has been only one sys ema ic e iew o he impac o Ac i e Lea ning o da e [
49
].
The au ho s aimed o in es iga e he me hods used in in e en ions o p omo e PA h ough
physically ac i e lessons while main aining academic ime. All ele en s udies in he e iew
ound imp o ed PA ollowing classes wi h Ac i e Lea ning, ei he in he whole in e en ion
g oup o in speci ic demog aphics. Educa ional ou comes ei he signi ican ly imp o ed o
we e no di e en compa ed wi h seden a y eaching.
Sus ainabili y 2023,15, 3806 9 o 22
Ma hema ics is he mos common ocus o s udies in es iga ing he e ec s o in e-
g a ed PA on academic lea ning. Howe e , Fi s Language, Fo eign Languages, Science,
Geog aphy, and gene al academic pe o mance ha e also been in es iga ed [
50
]. Fo
example, Mullende -Wijnsma, Ha man, de G ee , e al. [
51
] de eloped ac i e academic
class oom lessons, p ima ily ocusing on he epe i ion and memo iza ion o ein o ced
concep s in ma hema ics and language. O e all, assessmen s showed inc eased on- ask
beha io and signi ican ly highe es esul s (e.g., [52]).
These s udies could be amed as a single hypo hesis: child en in Ac i e Lea ning
condi ions ou pe o m hose in non-ac i e condi ions in bo h immedia e and delayed es s.
This hypo hesis was suppo ed by he li e a u e, al hough i is unclea whe he his is due
o he in eg a ion o PA in class oom lessons o PA pe se. Posi i e e ec s could simply
be due o he wide a ie y in physical and cogni i e de elopmen , which is ypical wi h
child en. This was e lec ed in he high s anda d de ia ions in indings. O pe haps esul s
we e a ec ed by he di e en ypes, in ensi ies, and le els o ac i i y in which child en in
o he condi ions we e in ol ed and he ele ance o hose PAs o cogni i e asks.
Conside ed as a whole, hese indings sugges ha Ac i e Lea ning is a cos -e ec i e,
enjoyable, and mo i a ing s a egy o inc ease s uden s’ daily PA a school wi hou un-
de mining o he educa ional goals. On he con a y, he e idence sugges s ha e ec i e
Ac i e Lea ning p og ams can enhance academic pe o mance. The pape s e iewed he e
ein o ce he impo ance o acknowledging ha posi i e ou comes om Ac i e Lea ning
do no happen au oma ically; hey a e mos likely o be ealized in associa ion wi h a se ies
o conduci e ‘change mechanisms’. The success ul implemen a ion o Ac i e Lea ning
is associa ed wi h p oac i e leade ship and eache suppo , eache e icacy ega ding
mas e ing he p og ams, he ease o o ganizing Ac i e Lea ning sessions, he genuine
inclusion o Ac i e Lea ning in o lesson cu icula, and child en’s posi i e ecep ion o he
in e en ion. The e o e, Ac i e Lea ning will wo k mos e ec i ely when i is pa o a
whole-school app oach o p omo ing PA in school.
3.1.4. Ac i e Recess
Since i p esen s an oppo uni y o engage almos all s uden s in daily PA in an en i-
onmen ha o en includes space and acili ies, ecess has been iden i ied as a po en ially
aluable se ing o p omo ing PA [
53
]. Recen yea s ha e seen inc easing in e es in
p omo ing child en’s PA du ing school ecess using di e en s a egies, including he
in oduc ion o playg ound ma kings and games equipmen [54].
Six e iews we e ound ela ed o he ela ionship be ween school ecess and PA [
54
–
59
].
The e iews sugges ha ecess has he po en ial o con ibu e abou 40% owa ds daily PA
ecommenda ions [
54
], and he school en i onmen is a po en ially aluable se ing o PA
ini ia i es, pa icula ly schoolya ds du ing ecess [60].
Empi ical s udies sugges ha Ac i e Recess pe iods can con ibu e o imp o ed un-
damen al mo emen skills, weigh s a us, and cogni i e pe o mance (e.g., [
61
]). Howe e ,
PA beha io du ing ecess a ies widely depending on he space in which ecess akes
place [
62
], acili ies [
63
], gende [
64
], and social g ouping [
65
]. S udies ound ha ecess PA
was associa ed wi h aspec s o he school’s physical en i onmen ; o example, la ge play
spaces [
66
], adequa e equipmen [
67
], playg ound ma kings [
68
], and a clea di ision by
ac i i y ype ha e been epo ed o be e ec i e in p omo ing PA du ing ecess [57]. The e
is some e idence ha he physical en i onmen ac o s ha a ec PA du ing ecess di e
by he cul u e o li es yle o coun ies [69].
The sys ema ic obse a ion li e a u e shows ha he amoun o MVPA du ing ecess
a ies be ween 44% and 66% (e.g., [
70
,
71
]). Boys a e gene ally mo e ac i e han gi ls du ing
ecess, wi h boys ypically spending abou 50% o he ime in MVPA [
71
]. Boys end o play
in la ge g oups han gi ls and engage mo e in spo s ac i i ies, whe eas gi ls p ima ily
engage in seden a y play [
67
]. Gi ls end o engage in mo e p osocial beha io han boys,
whe eas boys engage in mo e an isocial beha io han gi ls [
71
]. Howe e , i needs o be
acknowledged ha he e a e inconsis en indings, p obably due o he issue o di e en
Sus ainabili y 2023,15, 3806 16 o 22
popula ion, and o en he in ol emen o quali ied eache s. Howe e , since hey a e ol-
un a y, hese ac i i ies end o be less success ul a eaching he ha des - o- each g oups o
s uden s. Specially designed in e en ions a e e ec i e wi h g oups such as gi ls and he
o e weigh /obese. The e idence discussed he e, he e o e, shows po en ially impo an
con ibu ions, bu none o hese should be accep ed as gi en; he choice o ac i i ies, he way
hey a e p esen ed and supe ised, and he unde lying e hos o he school spo s clubs and
p og ams a e o undamen al impo ance in de e mining any e ec s hey ha e on s uden s.
4. Conclusions
Due o he widesp ead p oblem o seden a ism and he sus ained ad ance o obesi y
among child en and adolescen s, egula PA has become a public p io i y. Today’s gen-
e a ion o child en is he leas ac i e in his o y. To e ec i ely add ess such high le els o
conce n, schools ha e been iden i ied as key se ings o p omo ing MVPA and educing
seden a y ime. Howe e , o mos Eu opean s uden s, schools a e s ill he se ings o he
mos seden a y pa s o hei day. Da a om longi udinal s udies wi h objec i e measu es
o PA sugges ha he s anda d model o a school is poo ly sui ed o he p omo ion o
PA as MVPA begins o decline and seden a y beha io begins o inc ease om a ound he
ime young child en i s en e schools [
127
]. Consequen ly, policymake s and p ac i ione s
should conside in es ing in Ac i e School concep s such as p omising esou ces and
oppo uni ies o school s uden s o be engaged in PA.
In addi ion o he sel -e iden alue o imp o ing child en’s and young people’s
well-being and comba ing ac o s associa ed wi h he educed quali y and leng h o hei
li es, embedding physical ac i i y wi hin all aspec s o school li e can posi i ely suppo
academic pe o mance and achie emen in a ela i ely low-cos and sus ainable way [
26
].
I may also help o educe anspo ’s majo con ibu ion o global CO
2
emissions [
128
].
Schools ha e se e al dis inc i e cha ac e is ics ha mean hey a e well-placed o ac as
ounda ional se ings o he p omo ion o “sus ainable physical ac i i y” [
129
], as well as
wide sus ainabili y goals:
•
Schools can each almos all child en, and ha e long- e m, in-dep h con ac wi h hem,
c ea ing a unique oppo uni y o each a wide ange o child en ac oss he popula ion,
ega dless o social backg ound [130];
•
This con ac happens du ing a c ucial pe iod o de elopmen , du ing which many
heal h- ela ed beha io s and in e es s a e o med which can be ca ied o wa d in o
la e li e [131];
•
Schools p esen a unique se ing o in eg a ing PA wi h o he sus ainabili y ela ed
messages [132];
•
Schools, especially p ima y schools, o en ac as hubs o communi y ac i i ies, c ea ing
a ocal poin o sus ainable PA oppo uni ies, bo h di ec ly (by o ganizing school-
based lea ning expe iences), and indi ec ly (by encou aging app op ia e ac i i ies a
home, in he neighbo hood, and du ing commu ing o and om school) [133];
•
In eg a ing PA, heal h, and o he sus ainabili y ela ed ma e ials in o school lessons
is likely o a signi ican ly lowe economic cos o local and na ional agencies ha
in oduce such con en in ex acu icula con ex s.
Each o he se ings o Ac i e Schools discussed in he p esen e iew ha e he po en ial
o add ime o PA, al hough i seems ha none will be able o do his alone. The posi i e
e ec s o many o he i ems cha ac e izing an Ac i e School concep a e based on igo ous
scien i ic e idence; o he s s ill equi e u he esea ch. PA se ings a school, such as
Ac i e B eaks, seem o inc ease s uden s’ PA le els bu depend on nume ous con ex ual
ac o s. Mo e eliable esea ch indings a e needed o suppo he in luence o Ac i e
Homewo k on child en’s PA. Posi i e ou comes om Ac i e Lea ning will only wo k
success ully as pa o a whole-school concep . Inconsis en indings abou Ac i e Recess
call o addi ional cla i ica ions. Fu he mo e, Ac i e T anspo o and om school needs
o be encou aged as cu en pa e ns a e a cause o conce n due o dec easing le els o
walking and cycling, and a shi owa ds g ea e ca use b ings wi h i conside able ha m

Sus ainabili y 2023,15, 3806 17 o 22
o he en i onmen . In ligh o he conside able a ia ion in Ac i e T anspo oppo uni ies
in di e en pa s o Eu ope, u he esea ch migh p o i ably na ow i s ocus on speci ic
coun ies’ policies, in as uc u e, and p ac ices. Addi ionally, and in he con ex o PE, he
p esen e iew e eals ha mos lessons need o inc ease he le el o MVPA and enhance
s uden s’ engagemen o s ongly a ec o e all PA le els. Finally, School Spo s can also
posi i ely impac PA depending on he ac i i ies and he unde lying e hos o he school
spo s clubs and p og ams.
The Ac i e School concep is called on o maximize s uden bene i s by combining
wo subs an ial e ec s ela ed o he p omo ion o PA, and he pa icipa ion and he
in e ac ion o all ac o s. By adding momen s o engagemen in PA h oughou he school
day, om ela i ely b ie and LPA bu s s om Ac i e Lea ning o longe pe iods, including
MVPA and VPA, in PE and school spo s, Ac i e Schools should con ibu e o he in eg a ion
o PA in all aspec s o school ime and li e beyond school. By combining posi i e ea ly
PA expe iences, as well as he de elopmen o app op ia e knowledge (e.g., o he ules
o games), skills (e.g., basic mo emen s), a i udes (e.g., posi i e eelings owa ds PA,
impo ance o in insic mo i a ion o sus ained pa icipa ion in PA), and alues (e.g.,
belie ing PA is impo an ), sus ained pa icipa ion in PA would be gua an eed. Ac i e
Schools aim o inc ease he quan i ies o PA, bu his is mos likely o happen when a en ion
is also paid o he quali y o hose PA expe iences. Thus, he mul i ac o ial na u e o an
Ac i e School concep o e s a holis ic p esen a ion o hese compe encies such ha , when
done well, he whole is g ea e han he sum o i s pa s.
The so-called ‘whole-school concep ’ unde lines he need o ocus on school-le el
change, he ole o each key s akeholde g oup (e.g., eache s and eache educa o s,
pa en s, school leade s, heal h specialis s) and he social and physical en i onmen s (e.g.,
engagemen and suppo among s akeholde s, playg ound, g een space), no only he
in e en ions wi hin he men ioned chances o p omo ing PA among you h.
Au ho Con ibu ions:
Concep ualiza ion, R.B. and C.S.; me hodology, R.B.; o mal analysis, R.B.;
w i ing—o iginal d a p epa a ion, R.B.; w i ing— e iew and edi ing, F.R. and C.S.; p ojec adminis-
a ion, C.S.; unding acquisi ion, C.S. All au ho s ha e ead and ag eed o he published e sion o
he manusc ip .
Funding:
This s udy was a pa o he ‘Heal hy and Physically Ac i e Schools in Eu ope’ (HEPAS)
p ojec , unded by he Eu opean Union’s E asmus+ scheme, g an numbe 2019-1-LU01-KA201-050112.
Acknowledgmen s:
We hank colleagues in he ollowing o ganiza ions o hei suppo : Uni e si é
du Luxembou g, In e na ional Spo and Cul u e Associa ion, Depo e pa a la Educacion y la Salud
(Spain), Eu opean Physical Educa ion Associa ion, and Magya Diakspo Szo e seg (Hunga y).
Con lic s o In e es : The au ho s decla e no con lic o in e es .
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