Background: Participants in Outdoor Education Programmes (OEPs) presumably benefit from these programmes in terms of their social and personal development, academic achievement and physical activity (PA). The aim of this systematic review was to identify studies about regular compulsory school- and curriculum-based OEPs, to categorise and evaluate reported outcomes, to assess the methodological quality, and to discuss possible benefits for students. Methods: We searched online databases to identify English- and German-language peer-reviewed journal articles that reported any outcomes on a student level. Two independent reviewers screened studies identified for eligibility and assessed the methodological quality. Results: Thirteen studies were included for analysis. Most studies used a case-study design, the average number of participants was moderate (mean valued (M) = 62.17; standard deviation (SD) = 64.12), and the methodological quality was moderate on average for qualitative studies (M = 0.52; SD = 0.11), and low on average for quantitative studies (M = 0.18; SD = 0.42). Eight studies described outcomes in terms of social dimensions, seven studies in learning dimensions and four studies were subsumed under additional outcomes, i.e., PA and health. Eleven studies reported positive, one study positive as well as negative, and one study reported negative effects. PA and mental health as outcomes were underrepresented. Conclusion: Tendencies were detected that regular compulsory school- and curriculum-based OEPs can promote students in respect of social, academic, physical and psychological dimensions. Very little is known concerning students’ PA or mental health. We recommend conducting more quasi-experimental design and longitudinal studies with a greater number of participants, and a high methodological quality to further investigate these tendencies.

Background: Theoretical and empirical studies indicate that dance can strengthen the participants' self. The aim of the systematic review is to give an overview of studies investigating the effects of dance interventions on aspects of the self (e.g., self-concept/-esteem). Research questions are: (a) What is the evidence of the reported effects on different aspects of the self in children/adolescents and in adults? (b) Which study approaches and designs are used and what characterizes the interventions? (c) What are the qualitative facets of the implemented studies and what are issues for future research? Methods: We searched online databases for English and German journal articles with the following main inclusion criteria: (i) Intervention study (qualitative and quantitative approaches) (ii) Investigation of aspects of the self (iii) Dance as intervention content. Two reviewers independently screened studies for eligibility using the PRISMA guidelines and assessed the methodological quality of the included studies. Results: Out of 24 included studies, 11 investigate a sample of children/adolescents and 13 an adult sample. The review showed that dance interventions can have positive effects on aspects of the participants' self. The review of studies with qualitative methodologies suggests: children/adolescents benefit in body-related perceptions, self-trust, self-esteem, self-expression and perception of dance-abilities; adults benefit in self-expression, self-efficacy, self-/body-awareness, self-development and self-confidence. Studies with quantitative methodologies report improvement especially for body-related perceptions in both populations. Contradictory results exist concerning self-esteem/-efficacy. The evaluated studies show a heterogeneous nature of populations, intervention contents, timeframes, outcomes, research methods and study quality. Evidence for each of the aspects is still poor due to the small number of studies on each construct, inconsistent findings or methodological shortcomings. Conclusions: This review indicates that dance may be a valuable approach to strengthen aspects of the self. However, as evidence for the different aspects of the self is still poor, further studies with high quality are required (e.g., large samples, active control group). Research considering the complexity and specificity of dance interventions in the design and reporting (e.g., choice of outcomes, presentation of intervention details) seem to be particularly suitable to capture the effects of dance considering its holistic nature.

Promoting a healthy lifestyle especially in adolescents is important because health-related behaviors adopted during adolescence most often track into adulthood. Longitudinal studies are necessary for identifying health-related risk groups of adolescents and defining target groups for health-promoting interventions. Multiple health behavior research may represent a useful approach towards a better understanding of the complexity of health-related behavior. The aim of this study was to examine the longitudinal association of health-related behavior patterns with change of weight status and self-rated health in adolescents in Germany. Within the framework of the longitudinal German Health Interview and Examination Survey for Children and Adolescents (KiGGS) and the Motorik-Modul (MoMo), four clusters of typical health-related behavior patterns of adolescents have been previously identified. Therefor the variables ‘physical activity’, ‘media use’ and ‘healthy nutrition’ were included. In the current study longitudinal change of objectively measured weight status (N = 556) and self-rated health (N = 953) in the four clusters was examined. Statistical analyses comprised T-tests for paired samples, McNemar tests, multinomial logistic regression analysis and two-way ANOVA with repeated measures. The prevalence of overweight increased in all four clusters. The health-related behavior pattern of low activity level with high media use and low diet quality had the strongest increase in prevalence of overweight, while the smallest and non-significant increase was found with the behavior pattern of a high physical activity level and average media use and diet quality. Only some significant relationships between health-related behaviour patterns and change in self-rated health were observed. High-risk patterns of health-related behavior were identified. Further, cumulative as well as compensatory effects of different health-related behaviors on each other were found. The information gained in this study contributes to a better understanding of the complexity of health-related behavior and its impact on health parameters and may facilitate the development of targeted prevention programs.

Background: The co-occurrence of multiple health behaviors such as physical activity, diet, and sedentary behavior affects individuals' health. Co-occurence of different health behaviors has been shown in a large number of studies. This study extended this perspective by addressing the co-occurrence of multiple health behaviors in multiple persons. The objective was to examine familial health behavioral patterns by (1) identifying clusters of families with similar behavior patterns and (2) characterizing the clusters by analyzing their correlates. Methods: Cross-sectional data were collected from 198 families (mother, father, and child). Mothers, fathers, and children completed questionnaires assessing health related behaviors (physical activity, consumption of “healthy” and “unhealthy” foods, and screen time), the perception of Family Health Climate (regarding physical activity and nutrition) and demographics. Twelve variables (four health behaviors of three family members) were included in a cluster analysis conducted with Ward's Method and K-means analysis. Chi-square tests and analyses of variance were performed to characterize the family clusters regarding their demographics and their perception of Family Health Climate. Results: Three clusters of families with specific behavioral patterns were identified: “healthy behavior families” with levels of physical activity and consumption of healthful foods above average and levels of media use and consumption of sweets below average; “unhealthy behavior families” with low levels of consumption of healthful foods and high levels of screen time; “divergent behavior families” with unhealthier behavioral patterns in parents and healthier screen time and eating behaviors combined with low physical activity levels in children. Family Health Climate differed between family clusters with most positive ratings in “healthy behavior families” and least positive ratings in “unhealthy behavior families.” “Divergent behavior families” rated the nutrition climate nearly as high as “healthy behavior families” while they rated the physical activity climate nearly as low as the “unhealthy behavior families.” Conclusions: The study shows that co-occurrence of multiple health behaviors occurs on the family level. Therefore, focusing the family as a whole instead of individuals and targeting aspects related to the Family Health Climate in interventions could result in benefits for both children and adults and enhance effectivity of intervention programs.

Little is known about the relationship between physical activity and health-related quality of life (HRQOL) in adolescents. The purpose of this study was 1) to quantify the predictive power of greater physical activity on higher HRQOL in adolescents and 2) to analyze whether the prediction is better for the sports club setting than for the leisure time setting. Within the framework of the German Health Interview and Examination Survey for Children and Adolescents and the “Motorik-Modul,” 1828 German adolescents aged 11−17 years completed a questionnaire concerning the amount of weekly physical activity at school, in sports clubs, and during leisure time. The KINDL-R questionnaire was used to assess HRQOL. Linear and multiple regression analyses were used to analyze the effects of physical activity on HRQOL. In regression analyses controlling for sociostructural variables, greater general physical activity was a significant predictor of higher HRQOL (P < .001). While greater physical activity in sports clubs significantly predicted higher HRQOL, greater physical activity during leisure time predicted higher HRQOL only to a certain level. Overall, the level of explained variance was low. Being physically active especially in sports clubs is positively linked to higher HRQOL of adolescents.

The displacement hypothesis predicts that physical activity and media use compete in adolescents; however, findings are inconsistent. A more differentiated approach at determining the co-occurrence of physical activity and media use behaviors within subjects may be warranted. The aim of this study was to determine the co-occurrence of physical activity and media use by identifying clusters of adolescents with specific behavior patterns including physical activity in various settings (school, sports club, leisure time) and different types of media use (watching TV, playing console games, using PC / Internet). Cross-sectional data of 2,083 adolescents (11–17 years) from all over Germany were collected between 2009 and 2012 in the Motorik-Modul Study. Physical activity and media use were self-reported. Cluster analyses (Ward’s method and K-means analysis) were used to identify behavior patterns of boys and girls separately. Eight clusters were identified for boys and seven for girls. The clusters demonstrated that a high proportion of boys (33%) as well as girls (42%) show low engagement in both physical activity and media use, irrespective of setting or type of media. Other adolescents are engaged in both behaviors, but either physical activity (35% of boys, 27% of girls) or media use (31% of boys and girls) predominates. These adolescents belong to different clusters, whereat in most clusters either one specific setting of physical activity or a specific combination of different types of media predominates. The results of this study support to some extent the hypothesis that media use and physical activity compete: Very high media use occurred with low physical activity behavior, but very high activity levels co-occurred with considerable amounts of time using any media. There was no evidence that type of used media was related to physical activity levels, neither setting of physical activity was related to amount of media use in any pattern.