Changes in physical activity behavior in children and adolescents: a systematic review and meta-analysis based on a trans-theoretical model.

OBJECTIVE: This article presents a systematic review and meta-analysis of cross-sectional studies of physical activity (PA) behavioral changes in children and adolescents based on the trans-theoretical model (TTM). The main purpose is to test the rationality of TTM and the secondary purpose is to analyze whether PA can effectively identify the stages of change. MATERIALS AND METHODS: The databases CNKI, Wan-Fang, VIP, WOS, PubMed, and EBSCO were searched by computer. Two researchers independently reviewed the literature, extracted data, and evaluated the quality of the literature. Stata 23.0 software was used for statistical analysis. RESULTS: A total of 17 articles of medium and high quality were included in the meta-analysis. First, the behavior changes of PA of children and adolescents are related to the process of change (POC), self-efficacy (SEI), and decisional balance (DBL). The POC, SEI, and DBL have obvious stage characteristics. Second, with increasing intensity of PA, the degree of discrimination of stage of change (SOC) also improved, but PA could not still fully distinguish each stage. CONCLUSIONS: It is suggested that follow-up studies should compare the stages of change of different criteria by comprehensive behavioral data, exercise willingness, and exercise habits. Furthermore, it is recommended that more studies use longitudinal surveys or experimental interventions to test the rationality of TTM. It is suggested that the follow-up study design more standardized measurement tools to explore the change in PA behavior of children and adolescents. [ABSTRACT FROM AUTHOR]