Physical activity interventions to improve the health of children and adolescents in out of home care – A systematic review of the literature

Of the substantial literature on interventions to improve the poor health of children in out of home care, little focuses on lifestyle factors such as physical activity. This review identifies if physical activity interventions are effective for this population, and if so which type of activity and for what health outcomes. A systematic review of 14 social science and physical activity databases was conducted in November 2019. Included articles examined the effect of a physical activity intervention on any health or wellbeing outcome, for children or adolescents under 20 years of age whose primary condition for admission to care was abuse, neglect or parental incapacity. A final 12 studies were identified, dated from 1989 to 2019, covering nine countries and with a mix of designs; eight Randomised Control Trials (RCT's), three single group trials and one qualitative study. Most interventions showed benefit, with the best evidence for rhythmic movement on visual motor integration and behaviour, yoga in relation to balance, flexibility and muscle strength, and initiative or general recreation activities for self-concept, self-efficacy and general psychological temperament. However, for some studies the effect may be moderated by other co-occurring interventions, like group social activities. Further research is required before these results could be confidently generalised across different settings, with particular gaps in relation to children and young people residing in foster or kinship care and for studies examining the effect of sports participation. The results of this review indicate that physical activity could be an effective intervention to address health concerns for children in out of home care and should therefore be considered in policies and program design. It is important to note that specific types of activity could not yet confidently be recommended over others.