Table 2 Intervention outcomes for children, adult stakeholders and schools/communities

Birnbaum et al. (2002) [38]

Impact on fruit and vegetable consumption (from 4.88 + -0.06 servings to 5.80 + -0.05) and food choice (from a score of 5.90 + -0.16 to 6.54 + -0.16) for those exposed to environment changes, curriculum intervention and being peer leaders.

Carlsson & Simovska (2012) [47]

Changes in pupils’ action competence through increased knowledge (related to healthy behaviours and health determinants), self-confidence, communication skills and critical thinking.

Changes in school meal provision and PA-promoting environments, e.g., bicycle parking lot, road safety on the school and community levels.

Dzewaltowski et al. (2009) [40]

Intervention schools increased in PA while controls decreased from years 7 to 8. 3.7 % increase in physical activity after school, corresponding to an increase of 7.5 min per day. FV intake did not change over time compared to controls.

Self-efficacy of adult leaders was high before the intervention and remained high at all measurements.

Gådin et al. (2009) [44]

The outcomes reported are not the result of an evaluation, but rather the expected outcomes based on the changes made. These include empowerment and increased influence on their school life, leading to mental health benefits.

Change in school and community policy: adaptation of existing policies, rules and action plans, e.g., action plan against bullying. Physical changes to the school playground to increase PA and improve social relations between pupils.

Haapala et al. (2014) [41]

Increase in recess physically active play (from 30 to 49 %) and ball games (from 33 to 42 %) during the project, mainly due to males’ participation. However, PA decreased in the follow-up period. Pupils who spent recess outdoors increased from 17 to 33 % in the project period.

Change in the organisation of the school day, including more opportunities for PA. Development of facilities and equipment for PA during the project. At one school, networks with parents and municipality office-holders were established for PA promotion.

Hannay et al. (2013) [49]

Development of advocacy skills, enhanced self-esteem and confidence, and motivation to engage in further advocacy.

Parents reaped personal benefit from contributing to overcoming negative stereotypes.

Advocacy by participants led to changes in policies for credit towards physical education in an alternative setting and changes to a school bus route.

Linton et al. (2014) [45]

Implementation of environmental changes in schools and communities following advocacy activities e.g., extra lighting, salad bar, female-only swim time.

Orme et al. (2013) [39]

Improvements to school meals and dining environment reported by pupils.

Ríos-Cortázar et al. (2014) [42]

Changed behaviour, attitudes and norms: the programme had an impact on children’s cognitive, social and emotional levels, nutrition and physical activity.

Rowe et al. (2010) [43]

The learning process developed pupils’ advocacy skills.

Stronger relationship between school and community.

The intervention ensured the availability of healthy, affordable meals through the establishment of the Kids Café and supported an environment that promotes healthy eating behaviours.

Simovska & Carlsson (2012) [48]

Skills and competence: leadership increased the sense of responsibility and motivation in pupils, development of learning and competency. Development of social responsibility, e.g., considering younger peers.

Provision of healthy eating and PA opportunities and improved environment e.g., bicycle parking lot, road safety initiatives on the school and community levels.

Toussaint et al. (2011) [46]

Change in eating habits, e.g., less sugar intake, and increase in PA. Development of critical thinking, leadership and advocacy skills, enhancement of self-esteem and confidence, motivation to engage in higher education.

Change in family members: healthier eating habits, weight loss, increased PA.