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KidsOut! — promoting physical activity and reducing sedentary behavior among 8th graders


Adolescents’ physical activity (PA) is decreasing and sedentary behavior (SB) increasing alarmingly. Insufficient PA and excessive SB are both related to various health risks indicating that interventions to promote adolescents’ PA and to reduce their SB are needed. Schools have great potential to reach most adolescents, and in Finland, health education (HE) as stand-alone subject provides an excellent platform for health promotion.


To promote PA and reduce SB among 8th graders in Tampere, Finland. The KidsOut! -study included three parts: an Internet survey (2011), a measurement study (2011) and a randomized, controlled trial (2012-14).

Part 1: Internet survey 

The purpose of the survey was to examine 8th graders’ active commuting to school (AC) and leisure PA in the city of Tampere, Finland. Associations with psychosocial and environmental factors were also examined. In addition, the adolescents were asked about their possibilities and barriers to increase AC and leisure PA, the amount of their outdoor activities, use of PA facilities, participation in organized sports, perceived physical fitness, amount of screen time and sleep. The electronic survey was addressed to all 8th graders (n»1600) in the 16 secondary schools of Tampere. The students completed the survey in the Internet during one regular school lesson.

The survey was responded by 1464 students (88%). AC varied according to distance to school. Of those having distance of 3 kilometers or less only 60 % walked or cycled to school daily. Unwillingness to use the bicycle helmet, fluent bus connections and concern about the bicycle vandalism were the most common barriers to AC in short distances. One quarter of the students met the physical activity recommendations, boys more often than girls. Leisure PA was most commonly restricted by other doings and hobbies. Walking and cycling trails and parks were the most frequent places for leisure PA. Approximately 40 % of the adolescents exceeded the screen time recommendation of 2 hours daily.

Original publication (In Finnish):  

Olavi Paronen, Minna Aittasalo, Anne-Mari Jussila. KASIT LIIKKEELLE! Koulumatka- ja liikuntakysely Tampereella syksyllä 2011. Tampereen kaupunki, 2012.

Part 2: Measurement study 

The purpose of the measurement study was to examine the validity and repeatability of

The Hookie accelerometer of the UKK Institute for Health Promotion Research in relation to the commonly used Actigraph accelerometer. The study involved 20 participants aged 13–15 years, who completed a sequence of ten 2-minute activities while wearing both accelerometers. Both monitors proved comparable in assessing adolescents’ accelerations in typical free-living activities and in classifying the activities by intensity levels. Analysing raw accelerometer data with MAD values may thus enable the comparison of accelerometer results between different studies also in adolescents.

Original publication: 

Aittasalo M, Vähä-Ypyä H, Vasankari T, Husu P, Jussila A-M, Sievänen H. Mean amplitude deviation calculated from raw acceleration data: a novel method for classifying the intensity of adolescents´ physical activity irrespective of accelerometer brand. BMC Sports Science, Medicine and Rehabilitation 2015;7:18. DOI 10.1186/s13102-015-0010-0. 

Part 3: Randomized, controlled trial 

The purpose of the trial was to RE-AIM-evaluate ( an intervention developed for three HE lessons to increase PA and reduce SB among 8th graders. All city-owned secondary schools in Tampere (n = 14) were invited to the trial and were randomized in pairs to the intervention (n=7) and comparison group (n=7). A specific content on PA and SB based on Health Action Process Approach model was integrated into routinely scheduled three HE lessons with the help of educational material: SoftGIS-questionnaire followed by feedback views on adolescents’ current PA and SB, FeetEnergy-homework leaflet for adolescents, FeetEnergy-video in YouTube, FeetEnergy-poster for classroom and FeetEnergy-leaflet for parents. In the comparison group, standard HE lessons were held.

The primary indicators of Effectiveness were changes in PA and SB. The secondary indicators were psychosocial factors of PA and SB and parental interference with PA and SB. The measurement points were baseline, 4 weeks after the intervention (Follow-up 1) and 7 months from baseline (Follow-up 2), the last indicating also the measurement point for individual level Maintenance. The measures were accelerometers, 7-day activity diaries and questionnaires. The evaluation of Reach, Adoption and Implementation was based on the data collected during the intervention. Maintenance at organizational level was assessed two years after the intervention with a questionnaire to the HE teachers.

The intervention was feasible and had small favorable effects on students’ self-reported PA, intention to do PA and family norm in screen time. The effects on PA persisted until Follow-up 2. It is likely that for greater impacts the HE lessons should have been supported with other actions without compromising feasibility.

Original publications: 

Aittasalo M, Jussila A-M, Tokola K, Sievänen H, Vähä-Ypyä H, Vasankari T. Kids Out; evaluation of a brief multimodal cluster randomized intervention integrated in health education lessons to increase physical activity and reduce sedentary behavior among eighth graders. BMC Public Health 2019;9:415

Jussila AM, Vasankari T, Paronen O, Sievänen H, Tokola K, Vähä-Ypyä H, Broberg A, Aittasalo M. KIDS OUT! Protocol of a brief school-based intervention to promote physical activity and to reduce screen time in a sub-cohort of Finnish eighth graders. BMC Public Health 2015;15:634. 


KidsOut! -study was a part of a larger project, which examined the physical activity of children and adolescents in urban environment (Kids Out!). The collaborators of the project with the UKK Institute were Tampere University of Technology (School of Architecture) and Helsinki University of Technology (Centre for Urban and Regional Studies). The project was funded by the Ministry of Education and Culture as part of a research program on the health and welfare of children and young people (SKIDI-KIDS).


Minna Aittasalo, Senior Researcher  



For publications (international and Finnish) of this research see the Finnish description
To find the list of publications (Julkaisuja), scroll the page down. 

Last updated: 12.7.2023 

Last updated: 16.5.2024

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