Effectiveness and promising behavioral change techniques in interventions aimed at promoting physical activity in adolescents: a systematic review

Background: Eighty-one percent of adolescents aged 11–17 do not meet current international guidelines for achieving 60 min of moderate to vigorous physical activity daily, with activity levels declining from late childhood tracking into adulthood. This review aimed to summarize the effectiveness of physical activity interventions for adolescents aged 11–17 and analyze behavioral change techniques applied in these interventions, along with factors influencing intervention effectiveness, such as setting, length, theory base, and single versus multi-behavior approaches.

Methods: To ensure a carefully designed and well-conducted search, we collaborated with a medical information specialist to search the databases Medline, Embase, Scopus, ERIC, and Sport Discus up to August 2024 for relevant studies. Studies were included when they evaluated the effects of a physical activity, or a combined health promotion intervention with a physical activity component, on adolescents’ physical activity. One researcher extracted data and another researcher checked extractions, two independent researchers coded behavioral change techniques using the Behavior Change Technique Taxonomy v1, two independent researchers conducted quality assessment using the quality assessment tool of the Effective Public Health Practice Project.

Results: We included 70 studies evaluating 75 interventions. Six studies received a strong quality rating, 28 moderate, and 38 weak. Two studies were evaluated twice as they evaluated more than one intervention with different quality ratings. Behavioral demonstration, rehearsal, and instruction were the most frequently identified behavioral change techniques. 17 interventions reported significant positive effects on physical activity behavior. Behavioral change techniques applied were similar across effective and non-effective interventions, except for Social support, Self-monitoring, Feedback, Social reward, Prompts/cues, and Behavioral contract, which were more frequently applied in effective interventions.

Conclusions: Due to the lack of high-quality studies, we cannot draw strong conclusions regarding which BCTs should be applied in future PA interventions in adolescents. Nevertheless, the BCTs Social support in the form of encouragement and counseling, Self-monitoring, and Feedback of the behavior may be potentially promising strategies in interventions aimed at promoting PA in adolescents. High quality research using objective measurement methods is needed to determine the effectiveness of physical activity interventions for adolescents aged 11–17 and behavioral change techniques appropriate for this age group.