Developing a core outcome set for physical activity interventions in primary schools: a modified-Delphi study

Objectives: To develop a core outcome set (COS) for physical activity interventions in primary schools.

Design: Modified-Delphi study.

Setting: The UK and international.

Participants: 104 participants from four stakeholder groups (educators, public health professionals, health researchers, parents); 16 children (aged 8–9 years) from 1 London primary school.

Interventions: Physical activity interventions.

Methods: Four-stage process: (1) outcomes extracted from relevant studies identified from an umbrella review and a focus group; (2) list of outcomes produced and domains established; (3) stakeholders completed a two-round Delphi survey by rating (Round 1) and re-rating (Round 2) each outcome on a nine-point Likert Scale from ‘not important’ to ‘critical’: a>70% participant threshold identified the outcomes rated ‘critical’ to measure, and outcomes important to children were identified through a workshop; and (4) a stakeholder meeting to achieve consensus of the outcomes to include in the COS.

Results: In total, 74 studies were extracted from 53 reviews. A list of 50 outcomes was produced and three domains were established: ‘physical activity and health’ (16 outcomes), ‘social and emotional health’ (22 outcomes) and ‘educational performance’ (12 outcomes). 104 participants completed survey Round 1; 65 participants completed both rounds. In total, 13 outcomes met the threshold; children identified 8 outcomes. Fourteen outcomes achieved consensus to produce the COS: five outcomes for physical activity and health (diet (varied and balanced), energy, fitness, intensity of physical activity, sleep (number of hours)); seven outcomes for social and emotional health (anxiety, depression, enjoyment, happiness, self-esteem, stress, well-being); and two outcomes for educational performance (concentration, focus).

Conclusions: We have developed the first COS for physical activity interventions in primary schools in consultation with those interested in the development and application of an agreed standardised set of outcomes. Future studies including these outcomes will reduce heterogeneity across studies.


Kimberley A Foley, Esther van Sluijs, Dougal S Hargreaves, Russell M Viner, Sonia Saxena


Journal: BMJ Open
Volume: 12
Issue: 9
Pages: -
Year: 2022
DOI: 10.1136/bmjopen-2022-061335

Further Study Information

Current Stage: Completed
Date: February 2019 - September 2020
Funding source(s): The Daily Mile Foundation

Health Area

Disease Category: Child health, Public health

Disease Name: Obesity

Target Population

Age Range: 5 - 12

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Families
- Other
- Policy makers
- Researchers

Study Type

- COS for clinical trials or clinical research


- Consensus meeting
- Delphi process
- Literature review

We will conduct a modified Delphi study to identify the core outcomes of school-based physical activity interventions. We will identify potential outcomes through a comprehensive review of the literature, and then incorporate these into a Delphi survey consisting of two rounds. A variety of stakeholders (researchers, policy makers, teachers, head teachers, governors and parents) will be asked to participate in the Delphi survey, and then invited to attend a consensus meeting to achieve consensus on a final core outcomes set.

Linked Studies

    No related studies

Related Links