Examining Best Strategies in Physical Activity Interventions for Adolescent Girls: A Systematic Review

Purpose: Disparities in obesity among youth are closely reflected in the disparities in physical activity (PA) among youth. One startling disparity is a marked decline in PA among girls throughout the adolescent years, not seen among boys during the same age period. Adolescent girls experience barriers to PA connected to the physical, mental and social changes they experience during and after puberty. The trends of PA decline unmatched by any other demographic group and the presence of age- and gender-specific barriers to PA make adolescent girls a unique group with an immediate, high risk for becoming inactive. This inactivity would increase their lifelong risk for obesity-related diseases and high medical costs compared to active adolescents. The need for effective interventions to prevent and reverse the decline in PA among adolescent girls is well-understood among researchers, but how to best intervene is less understood. This paper aims to assess by systematic review whether PA promotion interventions for adolescent girls that 2) address psychosocial and behavioral skills, 2) have parental involvement, and 3) limit the sample to high-risk girls (e.g. inactive, obese) compared to interventions that do not fit those criteria, are more or less effective at attaining an increase in PA and an improvement in self-perceptions among adolescent girls.

Method: Eleven databases were included in the systematic search. The search was limited to scholarly peer-reviewed journal articles published between 2002 and February, 2013. A total of 21 summative evaluation studies on interventions with a PA component specifically for adolescent girls (mean sample age 9-19 years) were included in the review. Studies were assessed and given a score for methodological rigor using the Methodological Quality Rating Scale. Outcome attainment was determined by: 1) whether or not there was a statistically significant finding in the desired direction for PA and self-perception, and 2) whether a study showed above or below average methodological rigor.

Results: Interventions that had parental involvement were more effective at improving self-perceptions among the girls compared to interventions without parental involvement. Only nine of the total 21 interventions (42.9%) measured a self-perception outcome even though 15 of the 21 interventions (71.4%) contained psychosocial components. Interventions that addressed both psychosocial and behavioral skills were more effective at increasing girls’ PA compared to interventions that had a more physiological approach. Finally, interventions that sampled only high-risk girls were not as effective at increasing PA, but more effective at improving self-perceptions than the interventions that sampled the general population of girls.

Implications: The findings of this systematic review lend support for particular strategies involving parents, psychosocial and behavioral skills training, and sample selection for effectively increasing PA and improving self-perceptions among adolescent girls. When resources are sparse, these findings can aid social work researchers and practitioners in strategically selecting intervention components that will be most effective at narrowing the decline in PA among adolescent girls.