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A Systematic Review Investigating the Effects of Implementing Game-Based Approaches in School-Based Physical Education among Primary School Children

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Title: A Systematic Review Investigating the Effects of Implementing Game-Based Approaches in School-Based Physical Education among Primary School Children
Language: English
Authors: Yan, Jin (ORCID 0000-0003-3348-7241), Jones, Brad, Smith, Jordan J., Morgan, Philip (ORCID 0000-0002-5632-8529), Eather, Narelle (ORCID 0000-0002-6320-4540)
Source: Journal of Teaching in Physical Education. 2023 42(3):573-586.
Availability: Human Kinetics, Inc. 1607 North Market Street, Champaign, IL 61820. Tel: 800-474-4457; Fax: 217-351-1549; e-mail: info@hkusa.com; Web site: http://journals.humankinetics.com/journal/jtpe
Peer Reviewed: Y
Page Count: 14
Publication Date: 2023
Document Type: Journal Articles
Information Analyses
Reports - Research
Education Level: Elementary Education
Descriptors: Game Based Learning, Physical Education, Teaching Methods, Elementary School Students, Outcomes of Education, Self Concept, Student Motivation, Well Being, Instructional Effectiveness, Intervention, Educational Benefits, Mental Health, Physical Health, Child Development, Physical Development, Physiology, Motor Development
DOI: 10.1123/jtpe.2021-0279
ISSN: 0273-5024
1543-2769
Abstract: Purpose: To evaluate the effectiveness of game-based approaches on game performance, fundamental movement skills, health-related indicators, and physical activity outcomes among children (5-12 years) when delivered in the primary physical education school setting. Method: A systematic search of six electronic databases without date limitation was conducted on June 11, 2021. Results: Among included studies (N = 17), positive outcomes were found for children's game performance, fundamental movement skills, physical and mental health, and/or physical activity. Game-based approaches intervention success appears to be related to the contents of teacher training, especially the inclusion of a theory-based syllabus, mentoring, and reflection sessions. Conclusions: The findings of this review confirm that hybrid sport education-invasion games interventions delivered in primary schools are beneficial for improving a range of student outcomes. To improve physical self-perception, intrinsic motivation, well-being, physiological, and potential psychological outcomes for children, it is necessary to explore more game-based approaches' longitudinal and intervention research with high quality.
Abstractor: As Provided
Entry Date: 2023
Accession Number: EJ1396916
Database: ERIC
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  Value: <anid>AN0164611472;0do01jul.23;2023Jul03.05:17;v2.2.500</anid> <title id="AN0164611472-1">A Systematic Review Investigating the Effects of Implementing Game-Based Approaches in School-Based Physical Education Among Primary School Children </title> <p>Purpose: To evaluate the effectiveness of game-based approaches on game performance, fundamental movement skills, health-related indicators, and physical activity outcomes among children (5–12 years) when delivered in the primary physical education school setting. Method: A systematic search of six electronic databases without date limitation was conducted on June 11, 2021. Results: Among included studies (N = 17), positive outcomes were found for children's game performance, fundamental movement skills, physical and mental health, and/or physical activity. Game-based approaches intervention success appears to be related to the contents of teacher training, especially the inclusion of a theory-based syllabus, mentoring, and reflection sessions. Conclusions: The findings of this review confirm that hybrid sport education-invasion games interventions delivered in primary schools are beneficial for improving a range of student outcomes. To improve physical self-perception, intrinsic motivation, well-being, physiological, and potential psychological outcomes for children, it is necessary to explore more game-based approaches' longitudinal and intervention research with high quality.</p> <p>Keywords: game performance; game-based pedagogies; teacher training; teaching behavior; hybrid sport education</p> <p>Children of primary school age, (particularly prepubescent children aged 7–11 years) show the greatest capacity for learning and developing motor skills, and are the most responsive to motor skill training ([<reflink idref="bib6" id="ref1">6</reflink>]; [<reflink idref="bib57" id="ref2">57</reflink>]). High-quality physical education (PE) and fundamental movement skills (FMS) training lay the foundation for short- and long-term physical activity (PA) participation and positive health status ([<reflink idref="bib13" id="ref3">13</reflink>]; [<reflink idref="bib49" id="ref4">49</reflink>]), and for achieving and maintaining recommended health-related physical fitness levels ([<reflink idref="bib36" id="ref5">36</reflink>]; [<reflink idref="bib81" id="ref6">81</reflink>]). Schools play a significant role in facilitating motor skill development in children primarily through the delivery of PE and cocurricular school sport, but also through a variety of other PA opportunities (e.g., break time activities, curriculum-based PA integration, and classroom energizer breaks; [<reflink idref="bib42" id="ref7">42</reflink>]; [<reflink idref="bib56" id="ref8">56</reflink>]). PE is a formal part of the curriculum in most primary/elementary (hereafter "primary") schools worldwide ([<reflink idref="bib38" id="ref9">38</reflink>]), and aids the development of motor skills, by providing opportunities for deliberate practice in a wide variety of movement-based contexts (e.g., games and sports, gymnastics, dance, recreational activities; [<reflink idref="bib3" id="ref10">3</reflink>]; [<reflink idref="bib43" id="ref11">43</reflink>]).</p> <p>Game-based pedagogies (hereafter "game-based approaches" [GBA]) is an encompassing term for a range of alternative approaches to teaching a range of practice content within the PE curriculum ([<reflink idref="bib39" id="ref12">39</reflink>]; [<reflink idref="bib47" id="ref13">47</reflink>]). GBAs place learning within the context of game-like activities or game-related scenarios ([<reflink idref="bib30" id="ref14">30</reflink>]). What's more, GBAs require teachers to reposition themselves as facilitators and to use questions that enable students' reflection ([<reflink idref="bib11" id="ref15">11</reflink>]; [<reflink idref="bib39" id="ref16">39</reflink>]; [<reflink idref="bib75" id="ref17">75</reflink>]). The GBA technique was first introduced in English-speaking countries under the name of teaching games for understanding (TGfU) when Bunker and Thorpe ([<reflink idref="bib7" id="ref18">7</reflink>]) designed and developed the TGfU model as a method for helping PE teachers improve students' performance during games.</p> <p>After the introduction of TGfU, several variations of GBAs emerged globally ([<reflink idref="bib29" id="ref19">29</reflink>]), such as Game Sense (Australia; [<reflink idref="bib47" id="ref20">47</reflink>]), game-based coaching (New Zealand; [<reflink idref="bib20" id="ref21">20</reflink>]), tactical games model (United States; [<reflink idref="bib27" id="ref22">27</reflink>]), and the invasion games competency model (Belgium; [<reflink idref="bib77" id="ref23">77</reflink>]), each of which have common goals and methodologies ([<reflink idref="bib39" id="ref24">39</reflink>]). Game sense is game-based pedagogy with a specific focus on the play such as tactical understanding, reading the game, decision making, player independence, and a general sense of the game ([<reflink idref="bib48" id="ref25">48</reflink>]); Game-based coaching emphasizes contextualizing learning, and most importantly, introduced the emphasis on questioning in place of direct instruction ([<reflink idref="bib20" id="ref26">20</reflink>]); The tactical games model is an Americanized derivative of the TGfU approach ([<reflink idref="bib86" id="ref27">86</reflink>]), and the key learning outcomes are to develop understanding and use of tactics and skills in competition ([<reflink idref="bib40" id="ref28">40</reflink>]); invasion games have been considered the most physically active lessons and have the potential to directly increase PA levels in children ([<reflink idref="bib85" id="ref29">85</reflink>]). Despite slight variations in each of the above models, these game-based pedagogies all use game-like learning activities to facilitate skill development and learning.</p> <p>There are several notable strengths to adopting a GBA, especially in the development of FMS and game-related areas of PE (e.g., invasion games). For example, Miller et al. ([<reflink idref="bib62" id="ref30">62</reflink>]) reported improvements in FMS (e.g., object control competency, throw and catch) during an 8-week GBA intervention conducted in primary schools twice per week, when compared with normal PE classes. A growing body of research also shows that GBAs can improve students' cognitive capabilities ([<reflink idref="bib30" id="ref31">30</reflink>]), such as decision making ([<reflink idref="bib80" id="ref32">80</reflink>]), problem solving ([<reflink idref="bib71" id="ref33">71</reflink>]), and affective outcomes, such as fun, interest, and intrinsic motivation ([<reflink idref="bib78" id="ref34">78</reflink>]). Moreover, compared with traditional teaching approaches, GBAs aim to provide students with a more enjoyable learning experience that promotes initiative through the provision of appropriately difficult challenges within games ([<reflink idref="bib16" id="ref35">16</reflink>]). Liao et al. ([<reflink idref="bib46" id="ref36">46</reflink>]) reported that a GBA facilitates critical thinking and boosts the learner's comprehension of the environment. Previous studies have indicated that the critical thinking ability of children can be nurtured by applying student-centered tactics in PE, including problem-solving processes, collaboration, and discussion ([<reflink idref="bib32" id="ref37">32</reflink>]). The idea of game-based learning has also been supported by psychologists who have indicated the significance of play in the cognitive growth of children ([<reflink idref="bib14" id="ref38">14</reflink>]).</p> <p>The GBAs are assumed to help enhance tactical development, improving students' capacity to apply what is learned theoretically during authentic game experiences ([<reflink idref="bib39" id="ref39">39</reflink>]). Miller et al. ([<reflink idref="bib63" id="ref40">63</reflink>]) performed a trial of GBAs in seven elementary schools in Australia and found through GBA intervention, the development of motor skills can be improved in a relatively short period, which verifies that the improvements in the development of motor skills depend on the approach of intervention. In addition, GBAs are of great significance to the enhancement of motor skills, and these movement skills should be applied to the relevant activities so that the experience of contextual learning can be enhanced ([<reflink idref="bib62" id="ref41">62</reflink>]). Furthermore, the implementation of GBAs in primary schools has been considered to add a level of difficulty to PE lessons ([<reflink idref="bib63" id="ref42">63</reflink>]), as "quality" GBA instruction requires a higher standard of training and game understanding than required to deliver traditional PE pedagogy ([<reflink idref="bib33" id="ref43">33</reflink>]; [<reflink idref="bib34" id="ref44">34</reflink>]). Therefore, sufficient preservice training and preparation, and in-service professional development are critical for teachers to deliver GBA lessons effectively.</p> <p>Although the quality of teacher training in PA and PE interventions has been explored, several limitations could impede the sustainability of PA programs during in school time (e.g., low teaching confidence/competence, and lack of expertise/qualification; [<reflink idref="bib31" id="ref45">31</reflink>]; [<reflink idref="bib37" id="ref46">37</reflink>]; [<reflink idref="bib44" id="ref47">44</reflink>]; [<reflink idref="bib66" id="ref48">66</reflink>]). Teacher training is important to support teachers to acquire the necessary skills required for quality PE teaching ([<reflink idref="bib59" id="ref49">59</reflink>]). Furthermore, a range of factors may impact the quality of preservice training, for example, offering the appropriate theoretical framework, in-class mentoring, and reflection sessions, which can effectively improve student outcomes in FMS and/or PA ([<reflink idref="bib44" id="ref50">44</reflink>]). Although several studies have found a strong correlation between teacher training or professional development and improved PE teacher behaviors (e.g., instructional practices and reflection) in school-based PE ([<reflink idref="bib18" id="ref51">18</reflink>]; [<reflink idref="bib44" id="ref52">44</reflink>]; [<reflink idref="bib73" id="ref53">73</reflink>]), limited research has been conducted on teacher training within GBA interventions. Indeed, the major challenge to implementing quality PE is the lack of appropriate teacher training ([<reflink idref="bib83" id="ref54">83</reflink>]).</p> <p>Supporting the relationship between GBA and improved student outcomes, a systematic review published by Miller ([<reflink idref="bib61" id="ref55">61</reflink>]) explored the impact of GBA-focused programs on PE outcomes for children and adolescents (3–18 years), and found that GBAs could facilitate improvements in-game performance (game performance involves decision making, technical execution, cover [defense], support, and game involvement), and several affective outcomes (e.g., enjoyment, motivation, and self-perception). While this review provides a valuable contribution to our current understanding of the impact of GBA's, the authors focused on two outcomes—game-related skills and affect. A range of other health-related indicators, including physiological (e.g., weight status, physical fitness; [<reflink idref="bib9" id="ref56">9</reflink>]; [<reflink idref="bib79" id="ref57">79</reflink>]), psychological (e.g., self-esteem, anxiety; [<reflink idref="bib10" id="ref58">10</reflink>]), and FMS ([<reflink idref="bib93" id="ref59">93</reflink>]), physical activity outcomes (e.g., movement intensity, PA level; [<reflink idref="bib12" id="ref60">12</reflink>]; [<reflink idref="bib62" id="ref61">62</reflink>]) are commonly associated with GBAs. However, the effects of GBA's on such outcomes have not yet been synthesized. Therefore, the primary aim of the present study was to evaluate the effectiveness of GBA on game performance, FMS, health-related indicators, and PA outcomes among children (5–12 years) when delivered in the primary PE school setting.</p> <hd id="AN0164611472-2">Methods</hd> <p>This systematic review is registered with the International Prospective Register of Systematic Reviews ([<reflink idref="bib64" id="ref62">64</reflink>]), under registration number CRD42020183462.</p> <hd id="AN0164611472-3">Information Source and Search</hd> <p></p> <hd id="AN0164611472-4">Search Strategy</hd> <p>Following discussion with an academic librarian, a search strategy was developed, and the following six databases were systematically searched without date limitation on June 11th, 2021: EBSCO, EMBASE, ProQuest, PsycINFO, SCOPUS, and SPORTDISCUS. The search strategy included a combination of key search terms in four main areas : (a) setting: (Physical * OR "physical education" OR PE OR "sport education" OR SE), (b) target population: (child * OR student * OR player * OR "primary education" OR "elementary education" OR "elementary school" OR "primary school" OR school-aged), (c) intervention type (game * OR game-based OR "game sense" OR game-sense OR TGFU OR nonlinear OR tactical OR "tactical approach to teaching games" OR TATG OR GCA OR "game centered approach" OR "teaching games for understanding"), and (d) study design: (intervention * OR program * OR unit OR lesson * OR session * OR trial * OR experiment * OR "observation" OR "quasi-experimental").</p> <hd id="AN0164611472-5">Inclusion/Exclusion Criteria</hd> <p></p> <hd id="AN0164611472-6">The Inclusion Criteria for This Study</hd> <p></p> <ulist> <item> 1) Target participants were primary/elementary students aged 5–12 years (i.e., Grades 1–6).</item> <p></p> <item> 2) PE interventions or curriculum based, and programs conducted or implemented in primary schools (i.e., primary/elementary schools) during school hours by the schoolteacher within PE.</item> <p></p> <item> 3) Game-based methodologies/pedagogies adopted in intervention/program.</item> <p></p> <item> 4) The study provides a quantitative evaluation of the impact of game-based methodologies/pedagogies on children outcomes (e.g., physical activity levels, motor or game skills, psychological outcomes, affect, well-being).</item> <p></p> <item> 5) The study design is observational or experimental.</item> <p></p> <item> 6) Studies were published in peer-reviewed journals and written in the English language.</item> </ulist> <hd id="AN0164611472-7">The Exclusion Criteria for This Study</hd> <p></p> <ulist> <item> 1) Game-based interventions or programs conducted in organized or competitive sport outside of school or conducted in school but not in PE (after-school session or recess).</item> <p></p> <item> 2) The study conducted only qualitative research on the impact of game-based methodologies/pedagogies on child outcomes.</item> <p></p> <item> 3) Sample was a special population (i.e., elite athletes, children/youth/adolescents with health conditions).</item> <p></p> <item> 4) Conference proceedings, abstracts, dissertations, and gray literature.</item> <p></p> <item> 5) Studies were not written or published in the English language.</item> </ulist> <p>The initial search was conducted by the first author (Yan). Only articles published or accepted for publication in peer-reviewed journals were considered. Two researchers (Yan and Jones) then independently screened the abstracts of included articles, and any discrepancies were jointly discussed until a decision was made to either include or exclude the publication. Full-text articles were further evaluated independently for relevance by two authors (Yan and Jones) and labeled "yes," "no," or "maybe." The authors conferred and following discussion on any discrepancies, an agreement was achieved on all articles. The third stage was to scan the reference lists of included articles and identify additional relevant articles that were not located through the database search.</p> <hd id="AN0164611472-8">Assessment of Risk of Bias</hd> <p>Each article included in the study was independently evaluated by authors Yan and Jones based on the Cochrane Risk of Bias Tool (RoB 2.0; [<reflink idref="bib88" id="ref63">88</reflink>]). If these two researchers were unable to agree on the risk bias assessment, they consulted the third assessor (Eather) to reach a majority consensus. Each study was scored according to the following five criteria: (a) randomization process, (b) deviations from intended interventions, (c) missing outcome data, (d) measurement of the outcomes, and (e) selection of the reported results. The signaling questions in each domain had the following options: "yes/probably yes," "no/probably no," and "no information." By evaluating each of the five previously mentioned areas, the overall level of bias of each article is considered, and the overall risk of bias is assigned "low risk," "some concern," or "high risk." If all five areas are judged as low risk, the study is judged as having a low risk of bias; if at least one area is judged as being of some concern, the study is judged as some concern; if at least one area is judged as high risk, then the study is high risk.</p> <hd id="AN0164611472-9">Data Extraction Process</hd> <p>The data were extracted into Microsoft Excel 2016 by the first author (Yan) using a purpose-built template. The extracted content included author, date, study design, sample, country, age, aim, measurement, delivery method (teacher training), intervention and comparison group, finding and outcome, and then the data were checked by Jones and Eather. Since the included studies had substantial heterogeneity in the assessment of outcomes (i.e., game performance, FMS, PA level), and analytical methods (e.g., <emph>T</emph> test, Mann–Whitney's <emph>U</emph> test, Wilcoxon test, analyses of covariance, analysis of variance, linear mixed models, Kolmogorov–Smirnov tests), the meta-analysis was precluded.</p> <hd id="AN0164611472-10">Results</hd> <p></p> <hd id="AN0164611472-11">Overview of Studies</hd> <p>The flow of studies through the review process and all reasons for exclusion are shown in Figure 1. The initial search from six databases returned 4,674 articles, and after culling duplicates of 2,658 articles, 2,016 articles were remaining. During the review of article titles and abstracts, 1,947 studies were removed (788 studies were excluded by title and 1,159 studies were excluded by abstract) for not satisfying one or more of the inclusion criteria. There was a 98% agreement rate for inclusion/exclusion between the two reviewers (<emph>n</emph> = 40 articles, 2%), with all discrepancies jointly discussed until a decision was made to either include or exclude the publication. A total of 69 full-text articles were assessed for eligibility, and 56 were subsequently excluded for several reasons (Figure 1). Thirteen studies were identified for inclusion in the review; however, an additional four studies were identified and included after reviewing reference lists of included articles. Consequently, a total of 17 studies were included in the review (100% agreement).</p> <p>Graph: Figure 1 —Systematic reviews and meta-analysis (PRISMA) statement flowchart of studies through the review process. PA = physical activity; FMS = fundamental motor skill; GBAs = game-based approaches.</p> <hd id="AN0164611472-12">Study Characteristics and Participants</hd> <p>All included studies and study characteristics are shown in Table 1. The publication date of the articles included in the systematic review ranged from 2011 ([<reflink idref="bib4" id="ref64">4</reflink>]) to 2021 ([<reflink idref="bib24" id="ref65">24</reflink>]; [<reflink idref="bib25" id="ref66">25</reflink>]), and included randomized controlled trials (<emph>n</emph> = 5), observational studies (<emph>n</emph> = 7), and quasi-experimental studies (<emph>n</emph> = 5).</p> <p>Table 1 Study Characteristics</p> <p> <ephtml> <table><colgroup span="1"><col align="left" span="1" /><col align="center" span="1" /><col align="center" span="1" /><col align="center" span="1" /><col align="left" span="1" /><col align="left" span="1" /><col align="left" span="1" /><col align="left" span="1" /><col align="left" span="1" /><col align="left" span="1" /><col align="left" span="1" /><col align="left" span="1" /></colgroup><thead><tr><th rowspan="1" colspan="1">Citation</th><th rowspan="1" colspan="1">Sample size</th><th rowspan="1" colspan="1">Sex (F/M)</th><th rowspan="1" colspan="1">Age (years)</th><th align="left" rowspan="1" colspan="1">Study location</th><th align="left" rowspan="1" colspan="1">Duration</th><th align="left" rowspan="1" colspan="1">Study design</th><th align="left" rowspan="1" colspan="1">Game-based approach used</th><th align="left" rowspan="1" colspan="1">Delivery method (teacher training)</th><th align="left" rowspan="1" colspan="1">Outcomes assessed</th><th align="left" rowspan="1" colspan="1">Analysis</th><th align="left" rowspan="1" colspan="1">Study findings</th></tr></thead><tbody><tr><td rowspan="1" colspan="1">Arias-Estero et al. (<xref ref-type="bibr" rid="bibr2">2020</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 40</td><td rowspan="1" colspan="1">Boy = 13Girl = 27</td><td rowspan="1" colspan="1">Mean age = 9.44, <italic>SD</italic> = 0.45 years</td><td rowspan="1" colspan="1">Spain</td><td rowspan="1" colspan="1">16 lessons</td><td rowspan="1" colspan="1">Observation and experimental</td><td rowspan="1" colspan="1">TGFU</td><td rowspan="1" colspan="1">Receiving 30 hr instruction by authors; 3 hr per week for 10 weeks</td><td rowspan="1" colspan="1">Game performance (decision making, skill execution, cover, and support)</td><td rowspan="1" colspan="1">Friedman's χ<sup>2</sup>Wilcoxon's <italic>Z</italic> post hoc comparisons</td><td rowspan="1" colspan="1">There were improvements after both periods compared with the first assessment in-game performance</td></tr><tr><td rowspan="1" colspan="1">Balakrishnan et al. (<xref ref-type="bibr" rid="bibr4">2011</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 72</td><td rowspan="1" colspan="1">Boy = 72</td><td rowspan="1" colspan="1">10 years, Grade 4</td><td rowspan="1" colspan="1">Malaysia</td><td rowspan="1" colspan="1">6 weeks</td><td rowspan="1" colspan="1">RCTPretest and posttest</td><td rowspan="1" colspan="1">TGFU</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Cognitive learning</td><td rowspan="1" colspan="1">ANCOVA</td><td rowspan="1" colspan="1">A significant difference in the TGFU approach group about students' cognitive learning</td></tr><tr><td rowspan="1" colspan="1">Cocca, Carbajal Baca et al. (<xref ref-type="bibr" rid="bibr9">2020</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 188</td><td rowspan="1" colspan="1">Boy = 100Girl = 88</td><td rowspan="1" colspan="1">Mean age = 10.22 ± 0.76 yearsGrades 5–6</td><td rowspan="1" colspan="1">Mexico</td><td rowspan="1" colspan="1">6 months</td><td rowspan="1" colspan="1">Quasi-experimental</td><td rowspan="1" colspan="1">TGFU</td><td rowspan="1" colspan="1">PE teachers attending the theoretical and practical workshop</td><td rowspan="1" colspan="1">Physical fitness (flexibility, abdominals, and speed)</td><td rowspan="1" colspan="1">Standardized <italic>z</italic> scoresMahalanobis <italic>D</italic><sup>2</sup>Cohen's <italic>d</italic>ANCOVAs</td><td rowspan="1" colspan="1">EG obtained significantly higher scores than CG in flexibility, abdominals, speed, and handgrip</td></tr><tr><td rowspan="1" colspan="1">Cocca, Espino Verdugo et al. (<xref ref-type="bibr" rid="bibr10">2020</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 252</td><td rowspan="1" colspan="1">Boy = 133Girl = 119</td><td rowspan="1" colspan="1">Mean age = 10.24 ± 0.50 10–12 yearsGrades 5–6</td><td rowspan="1" colspan="1">Mexico</td><td rowspan="1" colspan="1">6 months</td><td rowspan="1" colspan="1">Quasi-experimental</td><td rowspan="1" colspan="1">Games-centered activities</td><td rowspan="1" colspan="1">PE teachers attending the theoretical and practical workshop</td><td rowspan="1" colspan="1">Health-related physical fitness components, psychological well-being, self-esteem, stress, and anxiety</td><td rowspan="1" colspan="1">Standardized <italic>z</italic> scoresMahalanobis <italic>D</italic><sup>2</sup>Cohen's <italic>d</italic>ANCOVAs</td><td rowspan="1" colspan="1">Significant differences at posttest were found in flexibility, handgrip strength, and stress EG.CG students, flexibility, handgrip strength, and abdominal strength obtained significantly higher scores at posttest.</td></tr><tr><td rowspan="1" colspan="1">Dania et al. (<xref ref-type="bibr" rid="bibr12">2017</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 91</td><td rowspan="1" colspan="1">NI</td><td rowspan="1" colspan="1">Mean age = 9.2 years<italic>SD</italic> = 0.7</td><td rowspan="1" colspan="1">Greece</td><td rowspan="1" colspan="1">6 weeks</td><td rowspan="1" colspan="1">Observation and experimental</td><td rowspan="1" colspan="1">TGFU</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Movement intensityActivity behavior</td><td rowspan="1" colspan="1"><italic>T</italic> tests</td><td rowspan="1" colspan="1">Statistically significant differences were recorded at the.05 significance level between the pre-and-postmeasurement scores of students' SPM.</td></tr><tr><td rowspan="1" colspan="1">Evangelio et al. (<xref ref-type="bibr" rid="bibr19">2019</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 57</td><td rowspan="1" colspan="1">Boy = 30Girl = 27</td><td rowspan="1" colspan="1">6 −12 years Grades 3–6</td><td rowspan="1" colspan="1">Spain</td><td rowspan="1" colspan="1">1 month</td><td rowspan="1" colspan="1">Observation and experimental</td><td rowspan="1" colspan="1">Small-sided games</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Physiological demands and tactical/technical knowledge</td><td rowspan="1" colspan="1">Kolmogorov–Smirnov testANOVA</td><td rowspan="1" colspan="1">Regarding the shot decision-making index, significant differences were found between the third and fifth grade students</td></tr><tr><td rowspan="1" colspan="1">Farias et al. (<xref ref-type="bibr" rid="bibr21">2015</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 24</td><td rowspan="1" colspan="1">Boy = 8,Girl = 16</td><td rowspan="1" colspan="1">Mean age = 10.44 ± 1.30 years</td><td rowspan="1" colspan="1">Portugal</td><td rowspan="1" colspan="1">17 sessions</td><td rowspan="1" colspan="1">Observation and experimental</td><td rowspan="1" colspan="1">Invasion games</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Game performance and understanding</td><td rowspan="1" colspan="1">Mann–Whitney and Wilcoxon tests</td><td rowspan="1" colspan="1">A significant measure of differences between males and females in overall decision making</td></tr><tr><td rowspan="1" colspan="1">Gaspar et al. (<xref ref-type="bibr" rid="bibr24">2021</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 111</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Mean age = 10.95 years<italic>SD</italic> = 0.64Grade 6</td><td rowspan="1" colspan="1">Spain</td><td rowspan="1" colspan="1">16 sessions</td><td rowspan="1" colspan="1">RCT</td><td rowspan="1" colspan="1">TGFU</td><td rowspan="1" colspan="1">90-min training session for PE teachers, including pedagogical principles of the TGFU model and questioning in student training</td><td rowspan="1" colspan="1">Motivation</td><td rowspan="1" colspan="1">Levene and Kolmogorov–Smirnov tests</td><td rowspan="1" colspan="1">TGFU improve motivation and the intention to develop healthy lifestyle habits in both genders</td></tr><tr><td rowspan="1" colspan="1">Gil-Arias et al. (<xref ref-type="bibr" rid="bibr25">2021</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 292</td><td rowspan="1" colspan="1">Boy = 152,Girl = 140</td><td rowspan="1" colspan="1">Mean age = 10.41 years<italic>SD</italic> = 0.49Grade 6</td><td rowspan="1" colspan="1">Spain</td><td rowspan="1" colspan="1">16 sessions (8 weeks)</td><td rowspan="1" colspan="1">Quasi-experimental</td><td rowspan="1" colspan="1">TGfU</td><td rowspan="1" colspan="1">PE teacher receiving a total of 10-hr training for 2 weeks, including theoretical and practical workshop</td><td rowspan="1" colspan="1">Self-determined motivation</td><td rowspan="1" colspan="1">Levene and Kolmogorov–Smirnov tests</td><td rowspan="1" colspan="1">Hybrid TGFU/SE units increase students' engagement, enjoyment, and social interactions in PE lessons</td></tr><tr><td rowspan="1" colspan="1">Mesquita et al. (<xref ref-type="bibr" rid="bibr60">2012</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 26</td><td rowspan="1" colspan="1">Boy = 9Girl = 17</td><td rowspan="1" colspan="1">10–12 yGrade 5</td><td rowspan="1" colspan="1">Portugal</td><td rowspan="1" colspan="1">22 sessions</td><td rowspan="1" colspan="1">Observation and experimental</td><td rowspan="1" colspan="1">Invasion games</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Skill execution and tactical decision making</td><td rowspan="1" colspan="1">Mann–Whitney test</td><td rowspan="1" colspan="1">Boys improved significantly in decision making from PrT to PoT-2 and from PoT-1 to PoT-2. Boys improved significantly from PrT to PoT-2 in defensive skill execution</td></tr><tr><td rowspan="1" colspan="1">Miller et al. (<xref ref-type="bibr" rid="bibr62">2016</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 107</td><td rowspan="1" colspan="1">Boy = 59Girl = 48</td><td rowspan="1" colspan="1">Mean age = 10.7 years<italic>SD</italic> = 0.87</td><td rowspan="1" colspan="1">Australia</td><td rowspan="1" colspan="1">7 weeks</td><td rowspan="1" colspan="1">Two-armed group RCT</td><td rowspan="1" colspan="1">GCA</td><td rowspan="1" colspan="1">PE teacher receiving a total of 2.5-hr training for 4 weeks, including theoretical and practical workshop</td><td rowspan="1" colspan="1">FMS; gameplay abilities of decision making, support and skill performance; in-class PA; and enjoyment of PA</td><td rowspan="1" colspan="1"><italic>T</italic> testsCohen's <italic>d</italic></td><td rowspan="1" colspan="1">Significant group-by-time intervention effects for throw (effect size: <italic>d</italic> = 0.9) and catch (<italic>d</italic> = 0.4) FMS, decision making (<italic>d</italic> = 0.7), and support (<italic>d</italic> = 0.9) during game play, and in-class PA (<italic>d</italic> = 1.6)</td></tr><tr><td rowspan="1" colspan="1">Miller et al. (<xref ref-type="bibr" rid="bibr63">2015</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 168</td><td rowspan="1" colspan="1">Boy = 72Girl = 96</td><td rowspan="1" colspan="1">Mean age = 11.2 years<italic>SD</italic> = 1.0</td><td rowspan="1" colspan="1">Australia</td><td rowspan="1" colspan="1">8 weeks</td><td rowspan="1" colspan="1">RCT</td><td rowspan="1" colspan="1">GCA</td><td rowspan="1" colspan="1">PE teacher receiving 1-day (6 hr) theory-based session and 5 weeks for teacher mentoring</td><td rowspan="1" colspan="1">Object control FMS proficiency and in-class PA</td><td rowspan="1" colspan="1"><italic>T</italic> testsCohen's <italic>d</italic></td><td rowspan="1" colspan="1">Significant group-by-time intervention effects for object control competency (effect size: <italic>d</italic> = 0.9), and in-class pedometer steps/min (<italic>d</italic> = 1.0)</td></tr><tr><td rowspan="1" colspan="1">Morales-Belando et al. (<xref ref-type="bibr" rid="bibr65">2018</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 41</td><td rowspan="1" colspan="1">Boy = 23Girl = 18</td><td rowspan="1" colspan="1">M = 11.73<italic>SD</italic> = 0.66</td><td rowspan="1" colspan="1">Spain</td><td rowspan="1" colspan="1">8 lessons</td><td rowspan="1" colspan="1">Quasi-experimental</td><td rowspan="1" colspan="1">TGFU</td><td rowspan="1" colspan="1">PE teacher receiving a total of 18 hr, 2 hr per week, lasting 9 weeksPE teachers attending the theoretical and practical workshop</td><td rowspan="1" colspan="1">Decision making, technical execution, cover, support, game performance, game involvement, enjoyment, perceived competence, and intention</td><td rowspan="1" colspan="1">Kolmogorov–Smirnov testES</td><td rowspan="1" colspan="1">Statistically significant differences were ratified by the high ES</td></tr><tr><td rowspan="1" colspan="1">Priklerová and Kucharik (<xref ref-type="bibr" rid="bibr72">2015</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 57</td><td rowspan="1" colspan="1">Boy and girls = 57</td><td rowspan="1" colspan="1">6 −10 yGrades 1–4</td><td rowspan="1" colspan="1">Slovakia</td><td rowspan="1" colspan="1">10 weeks</td><td rowspan="1" colspan="1">Observation and experimental</td><td rowspan="1" colspan="1">Tactical approach</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Game skills and game performance</td><td rowspan="1" colspan="1">Wilcoxon's <italic>T</italic> test.Mann–Whitney's <italic>U</italic> test</td><td rowspan="1" colspan="1">Significant changes in the technique of game skills in both age categories</td></tr><tr><td rowspan="1" colspan="1">Segovia and Gutiérrez (<xref ref-type="bibr" rid="bibr79">2020</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 154</td><td rowspan="1" colspan="1">Boy = 81Girl = 73</td><td rowspan="1" colspan="1">Mean age = 10.66 ± 0.82 years</td><td rowspan="1" colspan="1">Spain</td><td rowspan="1" colspan="1">15 sessions</td><td rowspan="1" colspan="1">Quasi-experimental</td><td rowspan="1" colspan="1">GB-HIIT</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">Body composition</td><td rowspan="1" colspan="1">Kolmogorov–Smirnov test.Shapiro–Wilk testMann–Whitney <italic>U</italic> test</td><td rowspan="1" colspan="1">Significant differences between the experimental group and control in waist circumference and body fat percentage</td></tr><tr><td rowspan="1" colspan="1">Sierra-Ríos et al. (<xref ref-type="bibr" rid="bibr82">2021</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 56</td><td rowspan="1" colspan="1">Boy = 36Girl = 20</td><td rowspan="1" colspan="1">Mean age = 9.04 ± 0.19</td><td rowspan="1" colspan="1">Spain</td><td rowspan="1" colspan="1">14 sessions</td><td rowspan="1" colspan="1">RCT</td><td rowspan="1" colspan="1">SSGs</td><td rowspan="1" colspan="1">NR</td><td rowspan="1" colspan="1">PA level</td><td rowspan="1" colspan="1">Shapiro–Wilk test and MANCOVA</td><td rowspan="1" colspan="1">Significant differences were observed in the group of SSGs in the internal load to light PA, %HRmax</td></tr><tr><td rowspan="1" colspan="1">Zhang and Cheung (<xref ref-type="bibr" rid="bibr93">2019</xref>)</td><td rowspan="1" colspan="1"><italic>N</italic> = 560</td><td rowspan="1" colspan="1">Boys = 321Girls = 239</td><td rowspan="1" colspan="1">Mean age = 7.54, <italic>SD</italic> = 0.94 6–9 yGrades 1–3</td><td rowspan="1" colspan="1">China</td><td rowspan="1" colspan="1">12 weeks</td><td rowspan="1" colspan="1">Quasi-experimental</td><td rowspan="1" colspan="1">Low-organized games</td><td rowspan="1" colspan="1">2-hr training sessions (theoretical and practical workshop) for PE teachers</td><td rowspan="1" colspan="1">FMS</td><td rowspan="1" colspan="1">ANOVACohen's standard method (<italic>d</italic>)</td><td rowspan="1" colspan="1">Significant interaction effect between group and grade on the locomotor skill score changes, and object control score change</td></tr></tbody></table> </ephtml> </p> <p> <emph>Note</emph>. ANOVA = analyses of variance; TGFU = teaching games for understanding; GCA = game-centered approach; GB-HIIT = game-based high-intensity interval training; FMS = fundamental motor skill; EG = experimental group; CG = control group; SSGs = small-sided games; RCT = randomized controlled trial; PA = physical activity; MANCOVA = multivariate analysis of covariance; NR = not report; SPM = steps per minute; ES = effect size; ANCOVA = analyses of covariance; PE = physical education.</p> <p>The 17 studies included involved nine countries, namely, seven in Spain ([<reflink idref="bib2" id="ref67">2</reflink>]; [<reflink idref="bib19" id="ref68">19</reflink>]; [<reflink idref="bib24" id="ref69">24</reflink>]; [<reflink idref="bib25" id="ref70">25</reflink>]; [<reflink idref="bib65" id="ref71">65</reflink>]; [<reflink idref="bib79" id="ref72">79</reflink>]; [<reflink idref="bib82" id="ref73">82</reflink>]), two in Portugal ([<reflink idref="bib21" id="ref74">21</reflink>]; [<reflink idref="bib60" id="ref75">60</reflink>]), Australia ([<reflink idref="bib63" id="ref76">63</reflink>], [<reflink idref="bib62" id="ref77">62</reflink>]), Mexico ([<reflink idref="bib9" id="ref78">9</reflink>]; [<reflink idref="bib10" id="ref79">10</reflink>]), one from Greece ([<reflink idref="bib12" id="ref80">12</reflink>]), Slovakia ([<reflink idref="bib72" id="ref81">72</reflink>]), China ([<reflink idref="bib93" id="ref82">93</reflink>]), and Malaysia ([<reflink idref="bib4" id="ref83">4</reflink>]). Included studies' sample size was between 24 ([<reflink idref="bib21" id="ref84">21</reflink>]) and 560 ([<reflink idref="bib93" id="ref85">93</reflink>]), totaling 2,296 primary school students.</p> <p>There are different types of GBA interventions included in this review, including tactical approach, game-based high-intensity interval training, hybrid sports education–invasion games competency model (SE-IGCM), small-sided games (SSG), low-organized games, TGfU, games-centered activities, and game-centered approach (GCA). The tactical approach is the variation of TGfU ([<reflink idref="bib72" id="ref86">72</reflink>]); SE-IGCM refers to a didactical framework designed to improve the depth of tactical learning and promote game performance under a game category, that is, the invasion games ([<reflink idref="bib21" id="ref87">21</reflink>]); SSG—conditioning games based on skill or training, which are modified versions of the full game, often played on reduced playing areas using adapted rules ([<reflink idref="bib23" id="ref88">23</reflink>]); low-organized games is defined as active, organized-group games and movement experiences that promote physical; cognitive; emotional; social learning; and encourage the development of bonding, initiative, autonomy, and trust for all individuals ([<reflink idref="bib89" id="ref89">89</reflink>]); GCA is defined as learning in play with the goal of linking learners and their skills, both physical and cognitive, to the demands of the play ([<reflink idref="bib41" id="ref90">41</reflink>]).</p> <hd id="AN0164611472-13">Measures</hd> <p>Included studies evaluated and measured the following aspects: Game skills and game performance ([<reflink idref="bib2" id="ref91">2</reflink>]; [<reflink idref="bib21" id="ref92">21</reflink>]; [<reflink idref="bib62" id="ref93">62</reflink>]; [<reflink idref="bib72" id="ref94">72</reflink>]), skill execution and tactical decision making ([<reflink idref="bib60" id="ref95">60</reflink>]; [<reflink idref="bib62" id="ref96">62</reflink>]; [<reflink idref="bib65" id="ref97">65</reflink>]), and fundamental motor skill development ([<reflink idref="bib63" id="ref98">63</reflink>], [<reflink idref="bib62" id="ref99">62</reflink>]; [<reflink idref="bib93" id="ref100">93</reflink>]). Health-related outcomes reported on included: physiological outcomes such as body composition ([<reflink idref="bib79" id="ref101">79</reflink>]), health-related physical fitness, and psychological outcomes ([<reflink idref="bib9" id="ref102">9</reflink>]; [<reflink idref="bib10" id="ref103">10</reflink>]; [<reflink idref="bib24" id="ref104">24</reflink>]; [<reflink idref="bib25" id="ref105">25</reflink>]). Physical activity outcomes including movement intensity ([<reflink idref="bib12" id="ref106">12</reflink>]) and physical activity level ([<reflink idref="bib63" id="ref107">63</reflink>]; [<reflink idref="bib82" id="ref108">82</reflink>]) were also extracted.</p> <hd id="AN0164611472-14">Risk of Bias Assessment Results</hd> <p>Figure 2 illustrated that six studies were identified as low risk of bias, FMS (3/6; [<reflink idref="bib63" id="ref109">63</reflink>], [<reflink idref="bib62" id="ref110">62</reflink>]; [<reflink idref="bib93" id="ref111">93</reflink>]), health-related indicators (2/6; [<reflink idref="bib9" id="ref112">9</reflink>]; [<reflink idref="bib24" id="ref113">24</reflink>]), and only one study involving PA ([<reflink idref="bib82" id="ref114">82</reflink>]). There are total eight studies evaluated as some concerns, game performance (4/8; [<reflink idref="bib2" id="ref115">2</reflink>]; [<reflink idref="bib21" id="ref116">21</reflink>]; [<reflink idref="bib65" id="ref117">65</reflink>]; [<reflink idref="bib72" id="ref118">72</reflink>]), health-related indicators (4/8; [<reflink idref="bib10" id="ref119">10</reflink>]; [<reflink idref="bib19" id="ref120">19</reflink>]; [<reflink idref="bib25" id="ref121">25</reflink>]; [<reflink idref="bib79" id="ref122">79</reflink>]). Only three studies were characterized as high risk of bias, game performance (2/3; [<reflink idref="bib60" id="ref123">60</reflink>]; [<reflink idref="bib72" id="ref124">72</reflink>]), and only one regarding PA ([<reflink idref="bib12" id="ref125">12</reflink>]). Most of the studies adhered to study protocols (93.8%), using appropriate measurement tools for assessing study outcomes (87.5%) and applying outcomes available for participants (93.8%).</p> <p>Graph: Figure 2 —Risk of bias. PA = physical activity; FMS = fundamental motor skill.</p> <hd id="AN0164611472-15">Outcomes</hd> <p></p> <hd id="AN0164611472-16">Game Performance</hd> <p>In total, 7/17 studies examined changes in students' game performance. All seven studies' showed improvements (to varying degrees) in-game skills, tactical decision making, and skill execution among participants. For example, Miller et al. ([<reflink idref="bib62" id="ref126">62</reflink>]) reported that an 8-week GCA intervention resulted in a statistically significant improvement in decision making and support during the gameplay in the intervention group; however, no significant differences between treatment groups were observed for children's game skills (<emph>p</emph> =.624, <emph>d</emph> = −0.2), which means that control group was better, and enjoyment (<emph>p</emph> =.635, <emph>d</emph> = 0.1).</p> <hd id="AN0164611472-17">Fundamental Movement Skills</hd> <p>Only three of 17 studies involved the assessment of FMS, with all reporting statistically significant treatment effects for FMS, when employing a GBA intervention. The remaining studies consisted of interventions ranging from 7 to 12 weeks in duration, and all reported significant improvements in FMS outcomes, although the size of the treatment effects differed across skills (determined using Cohen's <emph>d</emph>). For example, the study by Zhang and Cheung ([<reflink idref="bib93" id="ref127">93</reflink>]) reported effect sizes for locomotor skills and object control skills of <emph>d</emph> = 0.54 and 0.63, respectively, when 560 children (6–9 years) were exposed to low-organized games over 12 weeks. Another study, which was conducted with 107 students (9–12 years), showed a different effect size in throwing (<emph>d</emph> = 0.54) and catching (<emph>d</emph> = 0.558) when using the same intervention program ([<reflink idref="bib63" id="ref128">63</reflink>], [<reflink idref="bib62" id="ref129">62</reflink>]).</p> <hd id="AN0164611472-18">Health-Related Indicators</hd> <p>Seven of 17 studies reported significant outcomes in physical fitness components ([<reflink idref="bib10" id="ref130">10</reflink>]), psychological well-being, self-esteem, motivation, stress, anxiety ([<reflink idref="bib10" id="ref131">10</reflink>]; [<reflink idref="bib19" id="ref132">19</reflink>]; [<reflink idref="bib24" id="ref133">24</reflink>]; [<reflink idref="bib25" id="ref134">25</reflink>]), and body composition (waist circumference and body fat percentage; [<reflink idref="bib79" id="ref135">79</reflink>]), after employing TGfU, game-centered activities, SSGs, and game-based high-intensity interval training.</p> <hd id="AN0164611472-19">Physiological</hd> <p>Of note, Cocca et al. ([<reflink idref="bib9" id="ref136">9</reflink>]) reported that significant differences were achieved in twice a week TGfU-based program, involving 188 children, on flexibility (cm; <emph>p</emph> <.001), abdominals (<emph>n</emph>), and speed (s) assessment (<emph>p</emph> <.001), and nonsignificant differences were reported for handgrip (kg), cardiorespiratory fitness, and lower limb power (cm; <emph>p</emph> >.01; [<reflink idref="bib9" id="ref137">9</reflink>]).</p> <hd id="AN0164611472-20">Psychological</hd> <p>Two studies assessed primary students' motivation via TGfU interventional program in PE classes, finding that TGfU is a great opportunity to improve participants' engagement, enjoyment, and social interactions in PE lessons ([<reflink idref="bib24" id="ref138">24</reflink>]; [<reflink idref="bib25" id="ref139">25</reflink>]).</p> <hd id="AN0164611472-21">Physical Activity</hd> <p>Overall, four of 17 studies involved PA and all reported statistically significant differences in students' step PA level (steps per minute), moderate to vigorous PA ([<reflink idref="bib12" id="ref140">12</reflink>]), and/or in-class PA level ([<reflink idref="bib63" id="ref141">63</reflink>], [<reflink idref="bib62" id="ref142">62</reflink>]; [<reflink idref="bib82" id="ref143">82</reflink>]) after participation in the SSGs and PLUNGE intervention programs. Priklerová and Kucharik ([<reflink idref="bib72" id="ref144">72</reflink>]) used the SOFIT instrument to record and measure 91 children's moderate to vigorous PA and steps per minute for 6 weeks. Another two studies ([<reflink idref="bib63" id="ref145">63</reflink>], [<reflink idref="bib62" id="ref146">62</reflink>]) reported that treatment groups had significantly high PA levels during game-based lessons than control conditions, however, Miller et al. ([<reflink idref="bib62" id="ref147">62</reflink>]) study reported the greatest effect (<emph>d</emph> = 1.6).</p> <hd id="AN0164611472-22">Discussion</hd> <p>The primary aim of the current systematic review was to evaluate the effectiveness of GBA on game performance, FMS, health-related indicators, and PA outcomes among children (5–12 years) when delivered in the primary PE school setting. All included studies reported positive benefits of using a GBA in primary school, including improved game performance, FMS levels, health-related indicators, and PA levels. However, these findings should be viewed with caution, as great heterogeneity was found in included studies.</p> <hd id="AN0164611472-23">Game Performance</hd> <p>High-level performances in sports require highly proficient skills levels, and often excellent decision making and cognitive ability ([<reflink idref="bib51" id="ref148">51</reflink>]; [<reflink idref="bib69" id="ref149">69</reflink>]; [<reflink idref="bib70" id="ref150">70</reflink>]). Expert performers make more effective and efficient responses to scenarios within game situations ([<reflink idref="bib22" id="ref151">22</reflink>]). It can be synthesized from all included study findings that (a) there are different effects between the extent of improvement and the gender, age of the students; (b) the hybrid sport education–invasion games competence model had a marked effect on students' decision making and skills execution when compared to TGfU, as there is great tactical demand for invasion games because the players should get familiar with all the game situations (e.g., requiring the clear awareness of the position of teammates and the number of opponents; [<reflink idref="bib65" id="ref152">65</reflink>]); and (c) teachers' comments and students self-reflection were shown to be crucial for intervention improvement. Priklerová and Kucharik ([<reflink idref="bib72" id="ref153">72</reflink>]) highlighted that third and fourth graders achieved greater improvements compared to Grades 1 and 2 students. This could be explained by the fact that children aged below 9 acquire knowledge by imitation when they are playing games, rather than learning knowledge by direct instruction, and their success in achieving a specific goal is associated with their natural maturation ([<reflink idref="bib45" id="ref154">45</reflink>]). This is supported by the findings of Navarro-Patón et al. ([<reflink idref="bib68" id="ref155">68</reflink>]) who reported greater levels of dribbling technique among older boys and girls. Regarding gender, two studies reported that boys outperformed girls in assessments of judgment and skill execution in pretesting, However, girls were shown to outperform boys in defensive skill execution following hybrid SE ([<reflink idref="bib60" id="ref156">60</reflink>]), and showed greater improvements than boys in decision making and skill execution using a hybrid training model, including TGfU and SE. For future studies, teachers should consider baseline gameplay skill levels among girls and boys, and across age groups, and adapt program learning activities to suit.</p> <p>The main pedagogical characteristics of the hybrid SE-IGCM teaching unit are to acquire enough skills to participate enthusiastically in the game and help students improve understanding, and employ appropriate strategies to deal with the complexity of the game ([<reflink idref="bib60" id="ref157">60</reflink>]). Therefore, it can be argued that a hybrid SE-IGCM might potentially increase pupils' game performance, notably in terms of skill efficiency and decision-making effectiveness. Additionally, the IGCM can aid students in developing tactical acumen and establishing a link between cognitive abilities and game efficiency reactions ([<reflink idref="bib21" id="ref158">21</reflink>]).</p> <hd id="AN0164611472-24">Fundamental Movement Skill</hd> <p>Studies have reported that FMS is associated with children's physical activity level, cognitive function development, and social and emotional development ([<reflink idref="bib52" id="ref159">52</reflink>]; [<reflink idref="bib54" id="ref160">54</reflink>]; [<reflink idref="bib76" id="ref161">76</reflink>]). Although there were limited studies that measured the impact of GBA on FMS, results revealed that the 5–10 years group could achieve greater improvements than the over 10 years group ([<reflink idref="bib93" id="ref162">93</reflink>]). This may be due to children aged 5–10 years having a greater capacity to learn, develop, and master FMS, than older children. This is consistent with a previous study by Smith ([<reflink idref="bib87" id="ref163">87</reflink>]), who stated that FMS should be prioritized to develop during early childhood with a focus on technical competency rather than tactical awareness. Similarly, Smith ([<reflink idref="bib87" id="ref164">87</reflink>]) argued that students should pay more attention to the combination of FMS and game skills in the early stage, as this can provide better support for information processing, decision making, and game performance in future physical activities. Intervention using GBA in childhood is recommended preferably as it lays a foundation for the development of future skill performance. Furthermore, these results should be widely extended to sports activities outside of the classroom, which is a great strategy for making lessons more relevant to the wider world experience. These findings support the trans-contextual model of motivation that asserts that more enjoyable experiences in PE/sports can translate to higher PA participation outside of school ([<reflink idref="bib26" id="ref165">26</reflink>]).</p> <p>Regarding intervention sessions of pupils by gender, previous studies ([<reflink idref="bib1" id="ref166">1</reflink>]; [<reflink idref="bib91" id="ref167">91</reflink>]) indicated that gender has little influence on the results of the intervention experiment; however, the limited amount of research should encourage caution regarding this result. Finally, there is no clear evidence to support the notion that successful FMS interventions are related to the specific type of GBAs (e.g., TGfU, GCA) intervention ([<reflink idref="bib67" id="ref168">67</reflink>]), which appears to heavily depend on the quality of intervention (e.g., duration, syllabus, and measurements). Therefore, future studies on intervention should provide and design a basis for the different age and gender groups to meet their needs. Furthermore, it is recommended that future intervention studies should be explored in line with the beneficial impact on decision making, which is critical in the evolution of FMS.</p> <hd id="AN0164611472-25">Health-Related Indicators</hd> <p>In terms of health-related indicators of children, studies have confirmed that children taught with the PE-based TGfU model achieve higher scores than traditional PE in physical fitness (e.g., speed, flexibility, strength and cardiorespiratory fitness), and psychological well-being, self-esteem, motivation, stress, and anxiety ([<reflink idref="bib9" id="ref169">9</reflink>]; [<reflink idref="bib10" id="ref170">10</reflink>]; [<reflink idref="bib55" id="ref171">55</reflink>]). To be specific, students during TGfU sessions found they were at or above their target heart zone for a longer time than within traditional PE sessions in school ([<reflink idref="bib9" id="ref172">9</reflink>]). In addition to teaching methods, the improvement of cardiorespiratory fitness may also depend on the duration and frequency. For example, Trajković et al. ([<reflink idref="bib90" id="ref173">90</reflink>]) found that an 8-month small-sided soccer intervention can make a significant impact on physical fitness and psychological well-being in high school PE-based programs. Furthermore, another factor that should also be considered —the improvements in both groups might have also been determined by the fact that all participants, regardless of the assigned group, had very low fitness levels at pretest. It is known that fitness improvements are easier to obtain when the initial fitness level is low ([<reflink idref="bib35" id="ref174">35</reflink>]). Although these research results provide some evidence for the benefit of TGfU to promote the physical and mental health of children, more high-quality studies are needed to confirm this finding.</p> <p>Finally, several recommendations must be emphasized in future studies. First, the learning context must be designed to meet the needs of the children. Second, both boys and girls should have equal opportunities to participate and demonstrate their skills. A previous study ([<reflink idref="bib25" id="ref175">25</reflink>]) claims that girls have fewer chances to make decisions in a team leadership role, this would impede girls' social participation and engagement in PE. Third, researchers and practitioners should design and develop specific enjoyment scales to target the primary student population, especially given that current measurement tools may not be suitable for determining the true impact between PA and motivation (and affective outcomes; [<reflink idref="bib15" id="ref176">15</reflink>]).</p> <hd id="AN0164611472-26">Physical Activity</hd> <p>Compared with GBAs, direct instruction or linear methods (student centered) commonly require students to be "onlookers" in a lesson, and potentially not as active ([<reflink idref="bib74" id="ref177">74</reflink>]). Although just a few studies have measured differences in children's PA levels when exposed to GBA, the games played during GBAs maximize engagement of students in locomotor activities such as sprinting, dodging, running, etc. in doing so, large muscle groups are involved, and high levels of PA is sustained ([<reflink idref="bib23" id="ref178">23</reflink>]). A previous study demonstrated that there is a tension between both improving PA and developing game skills in PE class at the time ([<reflink idref="bib50" id="ref179">50</reflink>]). However, these studies have reached a consensus that the nonlinear GBAs intervention can be seen as the central vehicle responsible for promoting PA and skills learning simultaneously within school-based PE ([<reflink idref="bib12" id="ref180">12</reflink>]; [<reflink idref="bib63" id="ref181">63</reflink>], [<reflink idref="bib62" id="ref182">62</reflink>]). Similar research has also revealed that the game-based units centering on students in a self-determined environment provide opportunities for students to develop PA in a broad range of skill levels and ages ([<reflink idref="bib5" id="ref183">5</reflink>]; [<reflink idref="bib28" id="ref184">28</reflink>]). GBA essentially involves students learning a multitude of skills through gameplay, and as a result, PA level would inherently be high ([<reflink idref="bib8" id="ref185">8</reflink>]). This is supported by McCormick et al. ([<reflink idref="bib58" id="ref186">58</reflink>]) and Sierra-Ríos et al. ([<reflink idref="bib82" id="ref187">82</reflink>])'s statement that pupils exposed to SSGs could greatly enhance their opportunities to engage and achieve high levels of PA. Moreover, the PA level or movement intensity could be considered one of the most important indicators to measure children's participation or engagement in PE classes and examine PE lesson contribution to PA guidelines. Thus, future research should focus on effective teaching practices and student participation in active gameplay, which not only improves the level of PE-based PA, but also facilitates the FMS development among children, while at the same time, achieving the potential of cognitive ability through gameplay. The above findings explain how exposure to game-related scenarios maximizes opportunities for students to engage in skill practice.</p> <hd id="AN0164611472-27">Teacher Training</hd> <p>Teachers play an essential role in school-based intervention outcomes. A systematic review by Lander et al. ([<reflink idref="bib44" id="ref188">44</reflink>]) found that the type of teacher training associated with success in PE remains unknown and is generally poorly detailed. It has been well-documented that creating an integrated experience based on GBA is difficult for most primary/elementary students and learning concepts for performance and optimizing higher order thinking abilities takes a great deal of time ([<reflink idref="bib61" id="ref189">61</reflink>]). Consequently, it is crucial that effective teaching can be maintained in dynamic environments to promote learning in the timeframe required to accomplish this.</p> <p>More than half of the studies' (9/17) intervention programs were delivered and led by PE specialists or members of the research team, a set curriculum was designed and developed by the research team, specifically, the training session was combined with theoretical and practical aspects. Furthermore, these studies (9/17) found that high-quality studies (see ROB results) with training sessions were equipped with three primary phases: (a) engagement of teachers to deepen their understanding of GBA and theoretical frameworks; (b) mentoring to extend and support teachers during intervention delivery; and (c) providing feedback and reflection by dialogue or peer observation session, as peer dialogue is an effective and well-received method for improving teaching practices ([<reflink idref="bib17" id="ref190">17</reflink>]). The teacher learning environment matters and, just as effective learning for students usually occurs during gameplay, professional development for the teacher should happen within the context of the school setting/teacher's class. According to these studies (9/17), after participating in teacher training or professional development, teachers demonstrated great confidence, and willingness to continue to adopt GBA in the future. In a word, it is highly recommended to provide teachers with more training in GBA to increase their confidence, satisfaction, and self-efficacy.</p> <hd id="AN0164611472-28">Strengths and Limitations</hd> <p>Our review had several strengths. It is the first systematic review to analyze the effects of GBA interventions on game performance, FMS, health-related indicators, and PA level in primary schoolchildren. Our study also adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, included studies were rated by independent researchers using the Cochrane ROB criteria (with a high-agreement level), and provided a comprehensive database search with no limitations on publication date. Furthermore, an extensive extraction of key study characteristics was carried out.</p> <p>However, some limitations should be recognized. There was substantial heterogeneity among interventions, in terms of design, pedagogical approach, nature of training, and expertise of teachers. This makes it difficult to compare studies and draw conclusions regarding effective approaches or components. Future research needs to ensure more detail is provided regarding interventions and analysis conducted to ascertain the most successful strategies. The second one was that a large part of the included studies was rated at risk of moderate or high bias; therefore, the results of this review should be interpreted with caution. The third limitation was this study only investigated quantitative research on GBAs. Nevertheless, several qualitative studies ([<reflink idref="bib53" id="ref191">53</reflink>]; [<reflink idref="bib84" id="ref192">84</reflink>]; [<reflink idref="bib92" id="ref193">92</reflink>]) have been published in recent years which also focus on the impact of GBAs on children and adolescents. Compared with the quantitative data used in this review, qualitative research provides a more in-depth picture of the use of GBAs. Particular attention should be given to the most important affective fields (perspectives and/or perceptions from the teacher and student), which show the greatest effects on positive long-term health and health outcomes. This is difficult to measure quantitatively but can be covered more effectively using qualitative methodologies, such as interviews.</p> <hd id="AN0164611472-29">Conclusion</hd> <p>Evidence from 17 studies synthesized from this review illustrates that GBA interventions are capable of facilitating improvements in children's game performance, FMS, health-related indicates, and PA level outcomes. The hybrid SE-IGCM was shown to have a large effect on students' decision making, and skills execution in the real competition, with age and gender, being considered influencing factors for intervention success. Collected findings displayed that GBAs can be used as an effective opportunity to maximize the involvement of all students, and optimize their skill development, PA levels, and PA intensity levels during PE. As the teacher training process has not been elaborated on in most studies, the link between teacher training characteristics and students' outcomes is not clear. However, it is recommended that theory-based educational curriculums, mentoring, and reflection sessions in teacher training for GGA be developed and implemented. More high-quality GBAs longitudinal and intervention research should be explored as a sound basis for improving potential psychological, physiological, well-being, intrinsic motivation, and physical self-perception outcomes for children.</p> <p>Eather (narelle.eather@newcastle.edu.au) is corresponding author, https://orcid.org/0000-0002-6320-4540</p> <aug> <p>By Jin Yan; Brad Jones; Jordan J. Smith; Philip Morgan and Narelle Eather</p> <p>Reported by Author; Author; Author; Author; Author</p> </aug> <nolink nlid="nl1" bibid="bib6" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib57" firstref="ref2"></nolink> <nolink nlid="nl3" bibid="bib13" firstref="ref3"></nolink> <nolink nlid="nl4" bibid="bib49" firstref="ref4"></nolink> <nolink nlid="nl5" bibid="bib36" firstref="ref5"></nolink> <nolink nlid="nl6" bibid="bib81" firstref="ref6"></nolink> <nolink nlid="nl7" bibid="bib42" firstref="ref7"></nolink> <nolink nlid="nl8" bibid="bib56" firstref="ref8"></nolink> <nolink nlid="nl9" bibid="bib38" firstref="ref9"></nolink> <nolink nlid="nl10" bibid="bib3" firstref="ref10"></nolink> <nolink nlid="nl11" bibid="bib43" firstref="ref11"></nolink> <nolink nlid="nl12" bibid="bib39" firstref="ref12"></nolink> <nolink nlid="nl13" bibid="bib47" firstref="ref13"></nolink> <nolink nlid="nl14" bibid="bib30" firstref="ref14"></nolink> <nolink nlid="nl15" bibid="bib11" 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  Label: Title
  Group: Ti
  Data: A Systematic Review Investigating the Effects of Implementing Game-Based Approaches in School-Based Physical Education among Primary School Children
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Yan%2C+Jin%22">Yan, Jin</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-3348-7241">0000-0003-3348-7241</externalLink>)<br /><searchLink fieldCode="AR" term="%22Jones%2C+Brad%22">Jones, Brad</searchLink><br /><searchLink fieldCode="AR" term="%22Smith%2C+Jordan+J%2E%22">Smith, Jordan J.</searchLink><br /><searchLink fieldCode="AR" term="%22Morgan%2C+Philip%22">Morgan, Philip</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-5632-8529">0000-0002-5632-8529</externalLink>)<br /><searchLink fieldCode="AR" term="%22Eather%2C+Narelle%22">Eather, Narelle</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-6320-4540">0000-0002-6320-4540</externalLink>)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: <searchLink fieldCode="SO" term="%22Journal+of+Teaching+in+Physical+Education%22"><i>Journal of Teaching in Physical Education</i></searchLink>. 2023 42(3):573-586.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Human Kinetics, Inc. 1607 North Market Street, Champaign, IL 61820. Tel: 800-474-4457; Fax: 217-351-1549; e-mail: info@hkusa.com; Web site: http://journals.humankinetics.com/journal/jtpe
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 14
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2023
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Information Analyses<br />Reports - Research
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Elementary+Education%22">Elementary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Game+Based+Learning%22">Game Based Learning</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Education%22">Physical Education</searchLink><br /><searchLink fieldCode="DE" term="%22Teaching+Methods%22">Teaching Methods</searchLink><br /><searchLink fieldCode="DE" term="%22Elementary+School+Students%22">Elementary School Students</searchLink><br /><searchLink fieldCode="DE" term="%22Outcomes+of+Education%22">Outcomes of Education</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Concept%22">Self Concept</searchLink><br /><searchLink fieldCode="DE" term="%22Student+Motivation%22">Student Motivation</searchLink><br /><searchLink fieldCode="DE" term="%22Well+Being%22">Well Being</searchLink><br /><searchLink fieldCode="DE" term="%22Instructional+Effectiveness%22">Instructional Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Educational+Benefits%22">Educational Benefits</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+Health%22">Mental Health</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Health%22">Physical Health</searchLink><br /><searchLink fieldCode="DE" term="%22Child+Development%22">Child Development</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Development%22">Physical Development</searchLink><br /><searchLink fieldCode="DE" term="%22Physiology%22">Physiology</searchLink><br /><searchLink fieldCode="DE" term="%22Motor+Development%22">Motor Development</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1123/jtpe.2021-0279
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 0273-5024<br />1543-2769
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: To evaluate the effectiveness of game-based approaches on game performance, fundamental movement skills, health-related indicators, and physical activity outcomes among children (5-12 years) when delivered in the primary physical education school setting. Method: A systematic search of six electronic databases without date limitation was conducted on June 11, 2021. Results: Among included studies (N = 17), positive outcomes were found for children's game performance, fundamental movement skills, physical and mental health, and/or physical activity. Game-based approaches intervention success appears to be related to the contents of teacher training, especially the inclusion of a theory-based syllabus, mentoring, and reflection sessions. Conclusions: The findings of this review confirm that hybrid sport education-invasion games interventions delivered in primary schools are beneficial for improving a range of student outcomes. To improve physical self-perception, intrinsic motivation, well-being, physiological, and potential psychological outcomes for children, it is necessary to explore more game-based approaches' longitudinal and intervention research with high quality.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2023
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1396916
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1396916
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1123/jtpe.2021-0279
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 14
        StartPage: 573
    Subjects:
      – SubjectFull: Game Based Learning
        Type: general
      – SubjectFull: Physical Education
        Type: general
      – SubjectFull: Teaching Methods
        Type: general
      – SubjectFull: Elementary School Students
        Type: general
      – SubjectFull: Outcomes of Education
        Type: general
      – SubjectFull: Self Concept
        Type: general
      – SubjectFull: Student Motivation
        Type: general
      – SubjectFull: Well Being
        Type: general
      – SubjectFull: Instructional Effectiveness
        Type: general
      – SubjectFull: Intervention
        Type: general
      – SubjectFull: Educational Benefits
        Type: general
      – SubjectFull: Mental Health
        Type: general
      – SubjectFull: Physical Health
        Type: general
      – SubjectFull: Child Development
        Type: general
      – SubjectFull: Physical Development
        Type: general
      – SubjectFull: Physiology
        Type: general
      – SubjectFull: Motor Development
        Type: general
    Titles:
      – TitleFull: A Systematic Review Investigating the Effects of Implementing Game-Based Approaches in School-Based Physical Education among Primary School Children
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            NameFull: Yan, Jin
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            NameFull: Eather, Narelle
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2023
          Identifiers:
            – Type: issn-print
              Value: 0273-5024
            – Type: issn-electronic
              Value: 1543-2769
          Numbering:
            – Type: volume
              Value: 42
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: Journal of Teaching in Physical Education
              Type: main
ResultId 1