DE-PASS best evidence statement (BESt): determinants of adolescents’ device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

Background Although physical activity (PA) is associated with significant health benefits, only a small percentageof adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiabledeterminants of adolescents’ device-based PA and/or sedentary behaviour (SB), evaluated in previous interventionsand examined the associations between PA/SB and these determinants in settings.Methods A search was conducted on five electronic databases, including papers published from January 2010to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents’ device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligi-ble. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extractionadopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each studysetting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the cer-tainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked. PROSPERO ID:CRD42021282874.Results Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (inthe school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33broader determinants (21 individual–psychological, four individual–behavioural, seven interpersonal, and one insti-tutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings.The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found. Conclusions Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents’ device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well- designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents’ PA/SB, including policy and environmental variables.