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International Journal of

Environmental Research
and Public Health

Article
Effects of a SMART Goal Setting and 12-Week Core Strength
Training Intervention on Physical Fitness and Exercise Attitudes
in Adolescents: A Randomized Controlled Trial
Yijuan Lu 1 , Kehong Yu 1,2, * and Xiaomei Gan 1

1 Department of Sport Science, College of Education, Zhejiang University, Hangzhou 310027, China;
[email protected] (Y.L.); [email protected] (X.G.)
2 Center for Sports Modernization and Development, Zhejiang University, Hangzhou 310027, China
* Correspondence: [email protected]; Tel.: +86-180-7286-5097

Abstract: This study aimed to analyze the impacts of a 12-week core strength training (CST) and
goal-setting (GS) program on the core endurance, agility, sprinting, jumping, grip strength, and
exercise attitude in a group of adolescents. This study followed a randomized parallel design in
which 362 adolescents (age: 14.5 ± 1.07 years; body mass index: 19.82 ± 3.64) were allocated to a
GS (n = 89), CST (n = 92), or GS + CST (n = 90) program or to a control group (n = 91). Participants
were assessed two times (baseline and postintervention) for the following tests: (i) 50 m dash, (ii) grip
strength, (iii) long jump, (iv) 1000 m running for boys and 800 m for girls, (v) core endurance, and
(vi) exercise attitude. Significant differences (p < 0.05, η 2 p = 0.035−0.218) were found between the
four groups of the six components of physical fitness and the three components of attitude toward
exercise (target attitudes, behavioral habits, and sense of behavioral control). Between-group analysis
revealed that the GS + CST had significant advantages (p < 0.05) over the CON in terms of the
Citation: Lu, Y.; Yu, K.; Gan, X.
50 m dash (Cohen’s d = 0.06), grip strength (Cohen’s d = 0.19_left, 0.31_right), 800/1000 m running
Effects of a SMART Goal Setting and (Cohen’s d = 0.41), core endurance (Cohen’s d = 0.95), and sense of behavioral control (Cohen’s d = 0.35).
12-Week Core Strength Training Between-group analysis also revealed that the CST had significant advantages over the CON in terms
Intervention on Physical Fitness and of grip strength (Cohen’s d = 0.27_left, 0.39_right), 50 m (Cohen’s d = 0.04), long jump (Cohen’s d = 0.21),
Exercise Attitudes in Adolescents: A 800/1000 m (Cohen’s d = 0.09), and core stability (Cohen’s d = 0.63), which were significantly different
Randomized Controlled Trial. Int. J. from CON (p < 0.05). GS differed from CON only on 50 m (Cohen’s d = 0.02) and core stability (Cohen’s
Environ. Res. Public Health 2022, 19, d = 0.13) with a small effect (p < 0.05). We conclude that the combined intervention of GS and CST is
7715. https://doi.org/10.3390/ more effective in promoting fitness in adolescents, i.e., GS + CST > CST and GS + CST > GS.
ijerph19137715

Academic Editor: Paul B. Tchounwou Keywords: student; RCT; physical ability; attitude; core stability; target setting

Received: 23 May 2022


Accepted: 21 June 2022
Published: 23 June 2022
1. Introduction
Publisher’s Note: MDPI stays neutral The physical inactivity and declining physical health of adolescents have become a
with regard to jurisdictional claims in
global health problem. Studies have shown that no more than 45% of students meet the
published maps and institutional affil-
recommended level of 60 min of moderate and vigorous physical activity (MVPA) [1,2],
iations.
with only 8% of the adolescent population meeting the standard [3]. In Finland, 90% of
girls and 77% of boys did not meet the daily recommended physical activity in their self-
reports [4]. In several European countries, accelerometer measurements in children aged
Copyright: © 2022 by the authors.
10–12 years showed that only 4.6% of girls, as well as 16.8% of boys, meet the recommended
Licensee MDPI, Basel, Switzerland.
amount [5].
This article is an open access article According to nationwide surveys, the level of physical activity and health status of
distributed under the terms and Chinese school-aged youths showed a downward trend from approximately 22.7% in 2010
conditions of the Creative Commons to only approximately 8.9% in 2014 [6]. Although many policies have been put in place
Attribution (CC BY) license (https:// to improve adolescents’ PA levels, less than one-third of Chinese adolescents could meet
creativecommons.org/licenses/by/ the recommended level of 60 min of MVPA in 2016 [6]. As the physical activity level of
4.0/). teenagers can continue to decrease with age, which could be well above the recommended

Int. J. Environ. Res. Public Health 2022, 19, 7715. https://doi.org/10.3390/ijerph19137715 https://www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2022, 19, 7715 2 of 19

MVPA at 9 years but only 17% by 15 years [7], it is very important to conduct effective
interventions to improve the physical activity of Chinese adolescents.
Schools are important places for promoting physical activity [8], especially physical
education (PE) courses, which provide opportunities for students to not only participate
in sports but also develop the basic motor skills, knowledge, and attitudes needed for
lifelong physical activity. Because of the pressure to advance to higher education, ado-
lescent students face heavy study and homework burdens that greatly reduce their time
available for participating in extracurricular physical activities. Therefore, the physical
education classroom must become an important place for motivating students to participate
in moderate-to-vigorous physical activities. The importance of PE classes cannot be over-
looked [9–13] as they involve students in nearly every age group; therefore, high-quality
PE classes have a profound health impact on almost all secondary school students [14]. In
a systematic review of 14 studies of interventions to increase students’ effective learning
time in school physical education classes, Lonsdale et al. [11] found that students in the
intervention condition spent 24% more time in PE class for moderate-to-vigorous phys-
ical activity than students in the regular practice condition. The U.S. Physical Activity
Guidelines Study [15] also reported strong evidence for physical education interventions to
increase student physical activity levels in class, using key strategies such as (1) developing
and implementing a well-designed physical education schedule, (2) enhancing hands-on
instruction with a high level of moderate-to-vigorous physical activity, and (3) providing
appropriate training for teachers. Thus, it is clear that improving classroom teaching be-
haviors and the quality of instruction is necessary for promoting students’ physical activity
levels and physical health in the classroom.
In recent decades, there has been a significant increase in physical inactivity and
sedentary behavior among Chinese adolescents [16–18], which has been associated with
a decline in physical fitness [9] and a rising trend in obesity [19]. To this end, the state
has introduced a series of physical health promotion policies that have contributed to
the implementation of the guiding ideology of “health first,” the strengthening of school
physical education, the promotion of students’ active participation in physical activity,
the development of good exercise habits, and the improvement of physical health [8,20].
Among these policy efforts, the PE examination system (PES) plays an important role in
school sports, but it also produces many disadvantages brought about by “examination-
based education.” PE entrance examination for senior high school (PEeeshs) is an important
part of the PES. In China, every junior high school student must take a high school entrance
exam for physical education and the exam is worth 30–100 points toward the total score
of the junior high school entrance exam. The items of the test vary from province to
province and city to city in China. In Hangzhou, Zhejiang Province, where this study
was conducted, for example, the test items include endurance (1000 m/boys, 800 m/girls);
strength and jumping (solid ball throw, standing long jump, pull-ups/boys, sit-ups/girls);
and ball exercises: Soccer dribbling around the goal, volleyball mat, basketball dribbling
and lay-ups (one of three choices). The exams are tested by the local Ministry of Education
and are administered once a year, usually in April. To cope with the physical fitness test
and to improve the promotion rate and complete the task of PEeeshs, many schools turn
PE classes into “training classes” in the first year to cope with the PEeeshs. The main
teaching task of physical education teachers is to organize students to practice and pass the
PEeeshs, replacing the rich and interesting teaching content [21], which makes students
less motivated to exercise in PE class and indirectly affects their motivation and interest in
physical education outside of class.
The theory of planned behavior (TPB) proposed by Ajzen [22] can help us understand
how people change their behavior patterns. This model suggests that the most important de-
terminant of an individual’s behavior is their intention to perform that behavior, with three
cognitive variables—attitudes, subjective norms, and perceived behavioral control—which
are said to be the direct determinants of intention. Attitudes represent a key explanatory
variable in many theories of health behavior; research has shown that attitudes predict both
Int. J. Environ. Res. Public Health 2022, 19, 7715 3 of 19

intention and behavior [23]. The TPB provides a useful conceptual framework for marking
a sense of the complexities of human social behavior [24]. The attitude toward physical
activity is a combination of individuals’ cognitive evaluations, affective experiences, and
behavioral intentions related to physical activity [25], which are all essential psychological
factors for individuals to persist in physical activity, and adolescents’ positive attitudes
toward physical activity have positive impacts on their physical fitness [26].
Goal setting (GS) is a conscious and effective way to motivate individuals to be
physically active and is an important factor in successful behavior change. Planning is
ineffective without goals both short and long term. Goal-setting theory (GST), proposed
by Locke [27,28], argues that effective goals require five principles: Goals must be clear,
challenging, complex, and committed to and must also allow for feedback. Studies have
confirmed the effectiveness of GS for interventions related to students’ physical activity be-
haviors, such as works by Spruijt-Metz (2008) and Weaver (2017), who stated that teaching
students GS physical education lessons could be an effective strategy for promoting regular
physical activity and increasing aerobic fitness [29,30]; Wilson (2017) used GS for children’s
physical activity and enjoyment [31], and McDonald (2015) intervened with students by
arranging for them to receive a SMART GS curriculum [32], both of which showed some
intervention effects. Additionally, Japanese interventions for promoting students’ physical
strength attached great importance to GS, not only as the intended purpose of the activity
to achieve direction, motivation, and cohesion but also as a criterion for decision-making
and a basis for assessment. The contribution of GST applied to interventions is that by
quantifying it, exercise for students has a target reference and can serve as a form of motiva-
tion, but its disadvantage is that it is not easy to judge the rationalization of individual GS
in different contexts. The SMART principle of GS is one of the ways to set goals effectively
and was first proposed by management guru Peter Drucker in his book The Practice of
Management. The SMART principle consists of five components of effective goals: They
must be specific, measurable, attainable, relevant, and timely [33]. S stands for specific,
which means that the goal setting or performance evaluation criteria must be specific so
that people know what to do. M stands for measurable, which means that the goal or target
should be measurable and able to give clear judgment, such as through data. A stands for
attainable, which means that when setting goals for yourself or others, the goals should
not be too high or too low; if they are too high, it is easy to discourage people; if they are
too low and unchallenging, there is no need to work hard to reach them. R stands for
relevant, which means that there should be some relevance between the goal and the target,
regarding the overall goal or direction. T represents the time bounds, that is, the deadline
for a goal; if there is no deadline, then it is essentially invalid, which is the biggest enemy
of procrastination.
Core strength is a hot issue in current academic research [34,35], and many domestic
and international scholars have conducted theoretical studies on the concept including
the regions of the core and its effects on movement and rehabilitation [36–40]. Sharma
et al. [41] found a significant improvement in the force of continuous and obstacle jumps
after 9 months of trunk strength training, and Granacher et al. [42] found a significant
improvement in lateral jump tests after a core strength intervention. Prieske [43] also ob-
served significant improvements in trunk strength, sprinting, and other abilities after trunk
strength training. Kibler [37] argued that core stability not only generates force in human
movement but also carries the burden of transmitting force. Evidently, increased core
stability achieved through core strength exercises can promote the development of other
physical qualities. Past studies have also reported encouraging results through modified
physical education curricula, physical education teacher training, after-school physical
education interventions, and increased involvement of policymakers and parents. In China,
research on core strength exercises has mainly focused on the field of competitive sports
training, and there is little research on school sports that addresses student physical health
promotion. To this end, for this study, we designed an interesting core strength training
Int. J. Environ. Res. Public Health 2022, 19, 7715 4 of 19

Int. J. Environ. Res. Public Health 2022, 19, 7715 4 of 19


student physical health promotion. To this end, for this study, we designed an interesting
core strength training (CST) program for the physical exercise component of one school
system’s curriculum, replacing the original monotonous training content on the physical
(CST)
fitnessprogram
test. for the physical exercise component of one school system’s curriculum,
replacing the original
Based on the above,monotonous
this studytraining content
(1) proposes on the physicalintervention
a comprehensive fitness test. theoretical
Based on the above, this study (1) proposes a comprehensive intervention
framework based on TPB and GST, (2) designs an intervention program based theoretical
on the
framework based on TPB and GST, (2) designs an intervention program based
comprehensive intervention theoretical framework, and (3) aims to evaluate the effect on the
of
comprehensive
the interventionintervention
on enhancing theoretical framework,
adolescents’ and (3) aims
exercise attitudes andto evaluate
physical the effect of
fitness.
the intervention on enhancing adolescents’ exercise attitudes and physical fitness.
2. Materials and Methods
2. Materials and Methods
2.1. Study
2.1. Study Design
Design
This study
This studywaswasbased
basedonon thethe
TPBTPBandand
GSTGST as frameworks
as frameworks for designing
for designing the
the inter-
intervention
vention programprogram (shown
(shown in Figure
in Figure 1). Based
1). Based on TPB,
on TPB, our our study
study optimizes
optimizes the the content
content of
of physical fitness exercises in the physical education classroom, proposes
physical fitness exercises in the physical education classroom, proposes a core strengtha core strength
training (CST)
training (CST) program
program to toimprove
improvestudents’
students’ motivation
motivation and
and fitness,
fitness,and
andgives
givesstudents
students
quantitative goal-setting (GS) based on GST to motivate them to exercise.
quantitative goal-setting (GS) based on GST to motivate them to exercise. Four groups Four groups
were included: (1) Experimental group 1 (GS), which performed
were included: (1) Experimental group 1 (GS), which performed a goal-setting interven- a goal-setting
intervention
tion program;program; (2) experimental
(2) experimental group which
group 2 (CST), 2 (CST), which performed
performed a core-strength
a core-strength training
training intervention
intervention program;program; (3) experimental
(3) experimental group underwent
group 3, which 3, which underwent
a combined a combined
program
program
(GS + CST);(GS
and+ CST);
(4) theand (4) the
control control
group (CON),group (CON),
in which in which participants
participants were asked to were asked
maintain
to maintain
their their usual routines.
usual routines.

Figure1.1.Theoretical
Figure Theoreticalframework.
framework.

This
This 12-week
12-week RCT RCT followed
followed aa single-blinded
single-blinded designdesign and
and waswas performed
performed between
between
October 2020 and January 2021 (shown in Figure 2). This study
October 2020 and January 2021 (shown in Figure 2). This study was designed as a was designed as a random-
ized controlled
randomized trial. Before
controlled the
trial. trial was
Before initiated,
the trial the participants
was initiated, were randomly
the participants assigned
were randomly
to one of the
assigned to four
one groups usinggroups
of the four a computer-generated simple randomization
using a computer-generated simple procedure
randomization [44].
This RCT was
procedure reported
[44]. according
This RCT was to the Consolidated
reported according Standard of Reporting Trials
to the Consolidated (CON-
Standard of
SORT 2010) guidelines
Reporting (http://www.consort-statement.org
Trials (CONSORT (accessed on 15 June 2022)). In
2010) guidelines (http://www.consort-statement.org
addition,
(accessedaon concise
15 June overview
2022)). Inof addition,
the intervention
a conciseprograms
overview wasof described according
the intervention to the
programs
CONSORT 2010 checklist (http://www.consort-statement.org
was described according to the CONSORT 2010 checklist (http://www.consort- (accessed on 15 June 2022)).
This study lasted
statement.org 15 weeks,
(accessed on 15 during which This
June 2022)). the active
study intervention
lasted 15 weeks, was during
12 weeks,
which while
the
recruitment, screening, and pre- and post-measurement took
active intervention was 12 weeks, while recruitment, screening, and pre- and post-up the remaining 3 weeks.
In detail, the first
measurement tookweek wasremaining
up the used to screen for and
3 weeks. recruitthe
In detail, suitable subjects.
first week Then,toduring
was used screen
the second week, all students finished the questionnaire and fitness
for and recruit suitable subjects. Then, during the second week, all students finished test. Finally, in weekthe
15, the post-test procedure was identical to the baseline procedure after
questionnaire and fitness test. Finally, in week 15, the post-test procedure was identical tothe 12-week active
intervention
the baseline period.
procedure Theafter
CST and CST + GSactive
the 12-week intervention lastedperiod.
intervention for 12 weeks,
The CST three
andtimes
CST a+
week
GS intervention lasted for 12 weeks, three times a week for 7–10 min each time. Thethe
for 7–10 min each time. The GS intervention took place once in the first week. All GS
participants were tested two times: (a) Before the CST and GS and (b) 12 weeks after the
CST.
Int. J. Environ. Res. Public Health 2022, 19, 7715 5 of 19

Int. J. Environ. Res. Public Health 2022,intervention


19, 7715 took place once in the first week. All the participants were tested two times:
5 of 19
(a) Before the CST and GS and (b) 12 weeks after the CST.

Figure 2.
Figure Research design
2. Research design flow
flow chart.
chart.

2.2. Participants
2.2. Participants
Three hundred and sixty-eight students were chosen from eight classes in two middle
Three hundred and sixty-eight students were chosen from eight classes in two
schools in Hangzhou, Zhejiang Province, China, by random sampling, based on their
middle schools in Hangzhou, Zhejiang Province, China, by random sampling, based on
voluntary participation in this study. The inclusion criteria required that (a) students were
their voluntary participation in this study. The inclusion criteria required that (a) students
able to perform daily physical education classes, and (b) students did not participate in the
were able to perform daily physical education classes, and (b) students did not participate
school’s after-school sports club. Four students were excluded because they participated
in the school’s after-school sports club. Four students were excluded because they
in daily training with the school’s soccer club. Of the 368 candidates, 364 volunteers
participated in daily training with the school’s soccer club. Of the 368 candidates, 364
met the inclusion criteria, as described in Figure 3. Before the study, the demographic
volunteers met the inclusion criteria, as described in Figure 3. Before the study, the
information of these students was collected, then we allocated them to the intervention (GS,
demographic
CST, GS + CST) information
and controlofgroups.
these students
A total of was
364collected, then we
students were allocated
pretested them to and
at baseline, the
intervention (GS, CST, GS + CST) and control groups. A total of
two students (one in the GS + CST group due to a sprained ankle; one in the control group 364 students were
pretested at baseline,
due to transfer to anotherandschool)
two students
were lost(one in the GSat+the
to follow-up CST group All
posttest. duethe to participants
a sprained
ankle; one in
completed the
the control group
psychological due to transfer to another school) were lost to follow-up at
questionnaire.
the posttest. All the participants
Hence, a total of 271 students completed the psychological
of the intervention questionnaire.
group (138 boys and 133 girls) and
Hence, a total of 271 students of the intervention
91 subjects of the control group (44 boys and 47 girls) were analyzed group (138 boys and 133 girls) and
via screening and
91
cleaning data for questionnaires and the physical fitness test (shown in Table 1). Theand
subjects of the control group (44 boys and 47 girls) were analyzed via screening stu-
cleaning
dents’ meandata±forSD questionnaires
age and body mass and index
the physical
(BMI) were fitness
14.5test
± 1.07(shown
years inand Table
19.821). The
± 3.64,
students’ mean
respectively. All ±the
SDstudents
age andand body mass were
families indexfully(BMI) were 14.5
informed ± 1.07
about years and
the possible 19.82 ±
problems
3.64, respectively. All the students and families were fully informed
related to the experimental procedures. The study procedures were approved by the re- about the possible
problems related
search ethics board toofthe experimental
Zhejiang procedures.
University The study
(No.2020-002, procedures
22 July 2020). All were approved
the participants
by the research ethics board of Zhejiang University (No.2020-002,
gave written informed consent. The analyses were processed using the SPSS 25.0 program, 22 July 2020). All the
participants gavesize
except for effect written informed(Cohen’s
calculations consent.d), The analyses
which werewere processed
processed using using the SPSS
a web-based
25.0 program,
effect-size except (Effect
calculator for effect
Sizesize calculations
Calculator (Cohen’s d), which were processed using
(https://www.campbellcollaboration.org/ a
(ac-
web-based
cessed on 20effect-size
May 2022)). calculator (Effect isSize
This calculator Calculatorto (campbellcollaboration.org
a companion the 2001 book by Mark W.
(accessed
Lipsey and onDavid
20 May 20 2022)).
B. Wilson, This calculator
Practical is a companion
Meta-analysis, publishedto bythe 2001 book by Mark
Sage.
W. Lipsey and David B. Wilson, Practical Meta-analysis, published by Sage.
Int.
Int.J.J.Environ.
Environ.Res.
Res.Public
PublicHealth 2022,19,
Health2022, 19,7715
7715 6 of
of 19
19

Assessed for eligible students


(n= 368)
Excluded (n= 4)
Enrollment  Not meeting inclusion criteria
(n= 4)
Randomized (n= 364)

Allocation

Allocated to intervention, Allocated to intervention, Allocated to intervention, Allocated to control


GS (n= 90) CST (n= 92) GS+CST (n= 91) group (n= 92)
 Received allocated  Received allocated  Received allocated  Received allocated
intervention (n= 89) intervention (n= 92) intervention (n= 91) intervention (n= 92)

12-week follow-up
Lost to follow-up (n= 0) Lost to follow-up (n= 0) Lost to follow-up (n= 1) Lost to follow-up (n= 1)
 Illness  Transferring to
another school

Analysis
Analysed (n= 89) Analysed (n= 92) Analysed (n= 90) Analysed (n= 91)

Figure3.3.Flow
Figure Flowdiagram
diagramofofthe
thestudy
studyparticipants.
participants.

Table1.1.Participant
Table Participantcharacteristics.
characteristics.

GSGS CST
CST GSGS + CST
+ CST CON CON Total
Total p p
n 89
n= = 89 n 92
n= = 92 n =n90= 90 n = 91
n = 91 n = 362
n = 362
Grade
Grade
77 4343
(48.3%)
(48.3%) 4646
(50)
(50) 45 45
(50)(50) 44 (48.4)
44 (48.4) 173 173 0.992
0.992
88 4646
(51.7)
(51.7) 4646
(50)
(50) 45 45
(50)(50) 47 (51.6)
47 (51.6) 189 189
Gender
Gender
Boys 45 (50.6) 48 (52.2) 45 (50) 44 (48.4) 182 0.965
Boys 45 (50.6) 48 (52.2) 45 (50) 44 (48.4) 182 0.965
Girls 44 (49.4) 44 (47.8) 45 (50) 47 (51.6) 180
Girls 44 (49.4) 44 (47.8) 45 (50) 47 (51.6) 180
BMI (kg/m2 )
BMI (kg/m2)
BMI, Mean (SD) 20.37 (4.21) 19.47 (3.19) 19.57 (3.22) 19.86 (3.86) 19.82 (3.64) 0.346
BMI,<18.5
Mean (SD) 20.37
38 (4.21)
(42.7) 19.47
43 (3.19)
(46.7) 19.57
39 (43.3)(3.22) 4119.86
(45.1) (3.86) 19.82 (3.64) 0.346
18.5 ≤ <18.5
BMI < 24 38(36)
32 (42.7) 3943 (46.7)
(42.4) 43 39 (43.3)
(47.8) 41 (45.1)
37 (40.7)
18.5 ≥
≤ 24
BMI < 24 19 32
(21.3)
(36) 1039
(10.9)
(42.4) 8 43
(8.9)
(47.8) 13 (14.3)
37 (40.7)
Age (yr) ≥24 19 (21.3) 10 (10.9) 8 (8.9) 13 (14.3)
AgeAge,
(yr)Mean (SD) 14.54 (1.07) 14.59 (1) 14.42 (1.04) 14.46 (1.78) 14.5 (1.07) 0.727
13 19 (21.3) 13 (14.1) 22 (24.4) 28 (30.8)
Age, Mean (SD) 14.54 (1.07) 14.59 (1) 14.42 (1.04) 14.46 (1.78) 14.5 (1.07) 0.727
14 23 (25.8) 33 (35.9) 23 (25.6) 16 (17.6)
1513 2719 (21.3)
(30.3) 2613 (14.1)
(28.3) 30 22 (24.4)
(33.3) 28 (30.8)
24 (26.4)
1614 2023 (25.8)
(22.5) 1933 (35.9)
(20.7) 15 23 (25.6)
(16.7) 16 (17.6)
23 (25.3)
1715 0 (0)
27 (30.3) 126
(1.1)
(28.3) 030
(0)(33.3) 0 (0)
24 (26.4)
16 20GS:
(22.5) 19 (20.7)group; CST: 15
Goal setting intervention (16.7)
Core strength training 23 (25.3) group; GS + CST: Goal setting and
intervention
core strength training cointervention group; CON: Control group.
17 0 (0) 1 (1.1) 0 (0) 0 (0)
GS: Intervention
2.3. Goal setting intervention group; CST: Core strength training intervention group; GS + CST: Goal
setting and core strength training cointervention group; CON: Control group.
Experimental group 1 (GS) had one intervention in the first week and was assigned to
fill out the SMART GS card (shown in Figure 4) during the first week of the intervention.
2.3. Intervention
We designed goal questions for each item of the physical fitness test based on the SMART
Experimental
principle. group 1 (GS)
With the assistance had
of the one intervention
physical education in the first
teacher, theweek and was
GS groups assigned
of students
to fillout
filled outathe SMART GS at
questionnaire card
the(shown in Figure
beginning of the4) during
first the first
physical week ofperiod
education the intervention.
of the first
We designed goal questions
week of the intervention. for each item of the physical fitness test based on the SMART
principle. With the assistance of the physical education teacher, the GS groups of students
filled out a questionnaire at the beginning of the first physical education period of the first
week of the intervention.
Int.J.J.Environ.
Int. Environ.Res.
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Health2022,
2022,19,
19,7715
7715 77 of
of 19
19

Figure4.4.SMART
Figure SMARTgoal-setting
goal-settingcard.
card.

Experimental
Experimentalgroup group 2 (CST)
2 (CST) performed a coreastrength
performed training intervention
core strength program.
training intervention
CST consisted
program. CSTofconsisted
two themes, i.e., bobby
of two themes, jumps and agility
i.e., bobby jumpsladder
and assistance exercises,
agility ladder with
assistance
aexercises,
total of nine
withexercises
a total of(shown in Table(shown
nine exercises 2). The in CST was2).
Table performed
The CST was for approximately
performed for
7–10 min three times
approximately 7–10 per
minweek
threefor 12 weeks.
times per weekTablefor312
shows
weeks.theTable
phases3 of the CST
shows program.
the phases of
PE
theclasses for Chinese
CST program. PE adolescents last a total
classes for Chinese of 40 min last
adolescents andaconsist
total ofof40
three
minparts: The first
and consist of
isthree
the warm-up
parts: The part
first (approximately
is the warm-up part 7 min), the second is7 min),
(approximately the teaching
the secondandispractice part
the teaching
(approximately
and practice part (approximately 30 min), and the third is the relaxation The
30 min), and the third is the relaxation part (approximately 3 min). part
SCT intervention3took
(approximately min).place
The in SCTtheintervention
second half tookof theplace
second part.second
in the The active intervention
half of the second
and
part.measurements were mainly
The active intervention andcarried out by two
measurements trained
were mainly physical
carriededucation
out by twoteachers
trained
(M.G. and education
physical M.F.) from teachers
the experimental
(M.G. and schools.
M.F.)The intervention
from was conducted
the experimental by one
schools. The
teacher in grade 7 and one in grade 8. The pre-intervention researcher
intervention was conducted by one teacher in grade 7 and one in grade 8. The pre- first instructed and
trained the physical
intervention education
researcher teachers and
first instructed andprovided
trained eight sets of agility
the physical ladderteachers
education equipment
and
to the intervention schools.
provided eight sets of agility ladder equipment to the intervention schools.
Experimental group 3 underwent a combined program (GS + CST), and the control
Table 2. Core strength training content design.
group (CON) participants were asked to maintain their daily life routines.
Theme Core Strength Training Program Details
Table 2. Core strength training content design.
a. Squatting Down + Leg Thrust + Forward Jump + Vertical Jump
b. Theme
Squatting Down + Leg Thrust + Push-Up
Core Strength + Forward
TrainingJump + Vertical
Program Jump
Details
Bobby jump
c. Squatting Down + Leg Thrust + Prone lunge jump + Forward Jump + Vertical Jump
a. Squatting Down + Leg Thrust + Forward Jump + Vertical Jump
d. Squatting Down + Leg Thrust + Prone open and closed jump + Forward Jump + Vertical Jump
b. Squatting Down + Leg Thrust + Push-Up + Forward Jump + Vertical Jump
e. Lateral climbing
Bobby c. Squatting Down + Leg Thrust + Prone lunge jump + Forward Jump + Vertical
f. High bar leg run
Agile ladder g. jump Jump
Open and close jump
h. Mimic d. Squatting
spider crawlingDown + Leg Thrust + Prone open and closed jump + Forward Jump
i. Left and right lateral alternating
+ Vertical Jump feet jump
e. Lateral climbing
f. High group
Experimental bar leg3run
underwent a combined program (GS + CST), and the control
Agile
g. Open
group (CON) and close
participants jump
were asked to maintain their daily life routines.
ladder
h. Mimic spider crawling
i. Left and right lateral alternating feet jump
Int. J. Environ. Res. Public Health 2022, 19, 7715 8 of 19

Table 3. Phases of the CST program.

Week PE 1 PE 2 PE 3
1 [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 3 REP [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 3 REP [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 3 REP
2 [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 3 REP [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 3 REP [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 3 REP
3 [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 3 REP [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 3 REP [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 3 REP
4 [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 3 REP [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 3 REP [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 3 REP
5 [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 5 REP [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 5 REP [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 5 REP
6 [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 5 REP [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 5 REP [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 5 REP
7 [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 5 REP [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 5 REP [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 5 REP
8 [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 5 REP [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 5 REP [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 5 REP
9 [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 6 REP [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 6 REP [(a × 15 REP) + (f × 5 REP) + (g × 5 REP)] × 6 REP
10 [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 6 REP [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] ×6 REP [(b × 15 REP) + (f × 5 REP) + (e × 5 REP)] × 6 REP
11 [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 6 REP [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 6 REP [(c × 15 REP) + (g × 5 REP) + (h × 5 REP)] × 6 REP
12 [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 6 REP [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 6 REP [(d × 15 REP) + (e × 5 REP) + (i × 5 REP)] × 6 REP
REP: Repetitions; PE: Physical education.
Int. J. Environ. Res. Public Health 2022, 19, 7715 9 of 19

2.4. Measurements
2.4.1. Anthropometric Measures
Demographic indicators, including birth year, height, and weight, were obtained from
the laboratory school medical office staff.

2.4.2. Physical Fitness Test


With the assistance of the experiential schools, the physical fitness data were obtained
during the first week before the intervention, in strict accordance with the requirements of
the Chinese National Student Physical Fitness Test. Physical fitness tests were completed
by three trained experimenters assisting the physical education teachers. All tests (5 items)
were completed in one physical education classroom session. Before the test, students
completed a 5-minute warm-up exercise led by the physical education teacher. The tests
were arranged in the order of grip strength, long jump, 50-m dash, core endurance test, and
800-/1000-m run. Since the promulgation and implementation of the National Physical
Fitness Standards for Students in China in 2002, schools have been conducting tests of
the Standards every school year covering all grades of students in the school, and every
student knows the requirements and precautions for the tests, so teachers do not need a
detailed introduction.
Grip Strength The subject holds a grip strength device with the pointer facing outward
and adjusts it according to the size of the palm so that the second joint of the index finger is
close to a right angle, and the measurement is taken. The test subject’s body is straight, and
the feet are naturally separated. The grip should touch the body or one’s clothes as little as
possible and should not be swung back and forth during the measurement; it should be
kept as still as possible for the test. The measurements are taken in the order of right–left,
right–left two times for each hand.
Long Jump Each person jumps twice, and the measurement of the longer of the two
is used as the result. The test is taken barefoot or with rubber shoes but no shoes with
spikes or rubber soles. When jumping, a toe step on the line (including a toe step caused by
padding, continuous jumping, and other actions) is a foul, and the score is 0. A student is
also given zero points for landing backward into the invalid test area.
50 m Dash Subjects line up at the starting point in groups of five, and all run on
hearing the “ready, run” command. The test is over when the body reaches the vertical
surface of the finish line. It is considered a foul to push others, and the race will need to be
re-run.
800/1000 m Running Before the test, the teachers mobilized the students for a full
warm-up to mentally prepare them to do their best to complete the test. For students in
poor physical condition, the test duration was shortened.
Core Endurance To date, no test method can accurately and comprehensively reflect
core stability, and the lack of a gold standard has become an obstacle in research. Some
researchers have suggested that such a standard is not possible because of the item-specific
nature of core stability and that the choice of test should be based on the characteristics
of the item. Waldelm and Li [45] summarized the 34 most commonly used core stability
testing methods based on previous studies and classified them into five categories: Core
strength, core endurance, core flexibility, core motor control, and core functional testing.
Leitz [46] selected one test from each of the five categories, choosing trunk flexion and
extension, dominant leg standing, dominant leg hop, sit-ups, and extensor endurance to
comprehensively reflect core strength. For this study, we used a test designed by Brian
McKenzie, Senior Athletics Coach (UKA4) of UK Athletics, the national governing body
for athletics in the UK. Three trained experimenters accompanying the physical education
teachers completed the core endurance test. Prior to the test, each tester was assigned a pen,
a physical fitness test sheet (including core strength), and a clock. The testers demonstrated
and explained the eight test movements and requirements.
The content and order of the tests are as follows:
i. Participants will start in a planking position and hold for 60 s (1 point for completion).
Int. J. Environ. Res. Public Health 2022, 19, 7715 10 of 19

ii. Lift their right arm off the ground and hold for 15 s (3 points for completion).
iii. Return their right arm to the ground and lift the left arm off the ground and hold for
15 s (5 points for completion).
iv. Return their left arm to the ground and lift their right leg off the ground and hold for
15 s (6 points for completion).
v. Return their right leg to the ground and lift their left leg off the ground and hold for
15 s (10 points for completion).
vi. Lift their left leg and right arm off the ground hold for 15 s (15 points for completion.
vii. Return their left leg and right arm to the ground. Lift their right leg and left arm off
the ground hold for 15 s (25 points for completion).
viii. Return to the plank exercise position (elbows on the ground) and hold this position
for 30 s (35 points for completion).
It is important to note that the trunk is always in a neutral position throughout the
test, and the test must be performed continuously from the first step to the eighth step. If a
step in the test fails to meet the requirements, the test is over, and the total score obtained
at this point is the test result. The higher the score, the better the core strength and stability.

2.4.3. Physical Attitude Test


With the assistance of a physical education teacher, the researcher collected data on
participants’ attitudes toward exercise during the first week before the intervention. For this
study, we used the Exercise Attitude Scale [47] developed by Mao Rong-Jian to measure the
students’ attitudes toward physical activity. This scale has been included in the Handbook of
Evaluation of Commonly Used Scales in Sports Science, edited by Tension and Mao, and has
often been adopted by domestic researchers to collect physical activity attitudes of primary
and secondary school students and college students [25,48–53].
The scale contains the following domains: Behavioral attitudes (eight questions),
target attitudes (12 questions), behavioral perceptions (seven questions), behavioral habits
(10 questions), behavioral intention (eight questions), emotional experience (10 questions),
sense of behavioral control (eight questions), and subjective standards (seven questions).
Cronbach’s alphas for the eight subscales were 0.83, 087, 0.73, 0.89, 0.84, 0.86, 0.80, and
0.64, respectively, and the results of the total scale structure model test were x2 /df = 3.67,
NNFI = 0.93, CFI = 0.94, AGFI = 0.87, and RMSEA = 0.06, respectively, indicating that the
scale has good structural validity.

2.5. Statistical Procedures


We present descriptive statistics such as M, SD, and percentage where appropriate.
Chi-square statistics were used to compare the number of children in different groups based
on sex. The assumptions of the ANOVA were assessed to be satisfied based on the results
of the Shapiro-Wilk and Levene tests. When the data were not normally distributed, the
Mann–Whitney U test was performed for between-group comparisons and the Wilcoxon
matched-pair test was used for within-group comparisons. According to the Shapiro–Wilk
and the Levene test results, ANCOVA assumptions were met. Factorial univariate analysis
of variance (ANOVA) was used to compare baseline age, grade, gender, and body mass
index (BMI) among all groups and were corrected using Bonferroni adjustments when
needed. Cronbach’s alpha was assessed to determine the internal consistency for each
subscale of the Exercise Attitude Scale.
A factorial univariate analysis of covariance (ANCOVA) utilizing the baseline score
and other key confounders as covariates (age and BMI) was used to determine the effects
of the intervention. The within-subject factor was time (two assessment points: Baseline,
immediately after the intervention) and the between-subject factor was experimental condi-
tion (experimental vs. control). ANCOVA, which utilizes a baseline score as a covariate, is
recommended because it increases statistical power and precision [54]. Analyses of simple
effects and post-hoc Bonferroni adjustments were performed after significant interaction
effects by overall ANCOVA were confirmed. The calculated effect size was η 2 p , with
Int. J. Environ. Res. Public Health 2022, 19, 7715 11 of 19

effect sizes rated as follows: Small, 0.01 ≤ η 2 p < 0.06; medium, 0.06 ≤ η 2 p < 0.14; or large,
η 2 p ≤ 0.14 [55]. We set statistical significance at p < 0.05 for all tests. The effect sizes for
mean differences were expressed as Cohen’s d (difference in means divided by the standard
deviation of the difference) with values of 0.2, 0.5, and 0.8 denoting small, medium, and
large effect sizes, respectively [56].

3. Results
3.1. Effects of Intervention on Students’ Physical Fitness
An ANOVA was used to test for differences between groups for the baseline test.
The results showed that except for the significant difference in right-hand grip strength
(p = 0.03), the differences in the rest of the physical fitness tests were not significant. Gender
differences between groups were analyzed using the chi-square test, and p-values were
corrected using the Bonferroni method. The results showed that the gender differences
between the four groups were not significant (x2 = 0.273, p = 0.965).
The intra-group comparison for the physical fitness component is presented in Table 4.
The intervention groups presented a significant increase in both left and right handgrip
tests (GS: Cohen’s d = 0.09 and 0.15; CST: Cohen’s d = 0.72 and 0.81; GS + CST: Cohen’s d = 0.17
and 0.24). For 50 m and 800/1000 m, the intervention group showed a significant increase
in speed (GS: Cohen’s d = 0.22 and 0.17; CST: Cohen’s d = 0.4 and 0.55; GS + CST: Cohen’s
d = 0.32 and 0.56). Differences between groups also showed that the intervention group
significantly improved in the long jump and core endurance tests (GS: Cohen’s d = 0.25 and
0.21; CST: Cohen’s d = 0.51 and 0.49; GS + CST: Cohen’s d = 0.35 and 0.63). Additionally,
within-group changes in the control group were also significant for the long jump (p < 0.001,
Cohen’s d = 0.27) and 1000 m/800 m (p < 0.001, Cohen’s d = 0.25).

Table 4. Descriptive statistics of physical fitness variables (mean, standard deviation); within-group
analysis.

GS CST GS + CST CON


Variables
Pre Post d Pre Post d Pre Post d Pre Post d
Left-hand
20.1, 20.7, 18.7, 22.7, 21.1, 22.3, 20.7, 20.9,
grip 0.09 * 0.72 *** 0.17 *** 0.03
6.2 6.5 5.5 5.6 6.7 7.3 6.3 6.7
strength (kg)
Right-hand
21.3, 22.4, 20.4, 25.2, 23.1, 24.7, 22.5, 22.6,
grip 0.15 ** 0.81 *** 0.24 *** 0.01
7.0 6.8 5.9 6.18 6.7 7.1 6.9 6.8
strength (kg)
Long jump 168.5, 175.6, 170.5, 183.5, 172.9, 182.3, 171.0, 178.1,
0.25 *** 0.51 *** 0.35 *** 0.27 ***
(cm) 27.9 28.6 25.3 25.8 26.7 26.5 25.0 27.0
8.9, 8.7, 9.0, 8.7, 9.1, 8.8, 8.8, 8.7,
50 m (s) 0.22 *** 0.40 *** 0.32 *** 0.05
1.0 0.9 0.9 0.9 0.9 0.9 0.8 0.8
800/1000 m 4.7, 4.5, 4.7, 4.3, 4.4, 4.0, 4.6, 4.4,
0.17 ** 0.55 *** 0.56 *** 0.25 ***
(min) 0.9 1.0 0.9 0.8 0.7 0.7 1.0 1.0
Core
26.7, 33.7, 27.7, 43.6, 38.5, 61.9, 32.5, 29.3,
endurance 0.21 ** 0.49 *** 0.63 *** 0.09
30.98 35 31.4 33.8 38.7 35.1 38.0 31.5
(score)
GS: Goal setting intervention group; CST: Core strength training intervention group; GS + CST: Goal setting
and core strength training cointervention group; CON: Control group; statistical significance was set to p < 0.05;
“*”: p < 0.05; “**”: p < 0.01; “***”: p < 0.001.

The rapid physical and mental developments during adolescence are characterized by
significant gender differences. We included gender as a factor because of the significant
differences (p < 0.001) in the preintervention scores on six of the physical fitness test items
(excluding the 50 m dash, p = 0.189).
After controlling for age, BMI, and baseline scores, the results of the ANCOVAs
showed a significant group effect for the physical fitness component (left-hand grip strength:
F = 22.956, p < 0.001, η 2 p = 0.167; right-hand grip strength: F = 31.888, p < 0.001, η 2 p = 0.218;
50 m: F = 9.5, p < 0.001, η 2 p = 0.079; long jump: F = 4.041, p = 0.008, η 2 p = 0.035; 800/1000 m:
Int. J. Environ. Res. Public Health 2022, 19, 7715 12 of 19

F = 10.181, p < 0.001, η 2 p = 0.084; core endurance: F = 21.046, p < 0.001, η 2 p = 0.157). We
found no significant interactions between groups or for gender in the mixed ANCOVA for
the 50 m dash (p = 0.083, η 2 p = 0.020), grip strength (p = 0.417/0.317, η 2 p = 0.008/0.01), long
jump (p = 0.969, η 2 p = 0.01), 1000 m/800 m (p = 0.724, η 2 p = 0.004), and core endurance
(p = 0.076, η 2 p = 0.020). Table 5 present the results from between-group analyses.

Table 5. Analysis of covariance of physical fitness test indexes between experimental and control
groups.

Group Gender Interaction Effects Pairwise Comparison


Variables
F η2 p F η2 p F η2 p (Post)
Left-hand
con < CST, con < CST + GS,
grip Strength 22.956 0.167 *** 25.815 0.070 *** 0.949 0.008
CST > GS, CST > CST + GS
(kg)
Right-hand con < CST, con < CST + GS,
grip strength 31.888 0.218 *** 30.556 0.082 *** 1.180 0.010 GS < CST + GS, GS < CST,
(kg) CST > CST + GS
Long jump
4.041 0.035 ** 6.100 0.018 * 0.083 0.001 con < CST, GS < CST
(cm)
con < CST, con < CST + GS,
50 m (s) 9.500 0.079 *** 25.056 0.070 *** 2.240 0.020
con < GS, GS < CST
800/1000 m con < CST, con < CST + GS,
10.181 0.084 *** 0.579 0.002 0.441 0.004
(min) GS < CST, GS < CST + GS
Core con < CST, con < CST + GS,
endurance 21.046 0.157 *** 0.186 0.001 2.308 0.020 con < GS, CST + GS > GS,
(score) CST + GS > CST, CST > GS
The p-value is the result of the covariance test, setting age, BMI, and baseline test as covariates and group and
gender as fixed factors. “*”: p < 0.05; “**”: p < 0.01; “***”: p < 0.001.

Variables with significant differences were compared with the Bonferroni post-hoc to
further understand the differences between the four groups. For left-hand grip strength
performance, the CST was higher than the GS group by 2.97 kg (95%CI: 2.12–3.83, p < 0.001,
Cohen’s d = 0.05), higher than the CST + GS by 2.31 kg (95%CI: 1.45–3.18, p < 0.001, Cohen’s d
= 0.32), and higher than the control group by 3.24 kg (95%CI: 2.39–4.09, p < 0.001, Cohen’s d
= 0.27). CST + GS was higher than the control group by 0.93 kg (95%CI: 0.08–1.78, p < 0.05,
Cohen’s d = 0.19). For right-hand grip strength performance, CST was higher than the GS
group by 3.54 kg (95%CI: 2.61–4.46, p < 0.001, Cohen’s d = 0.43), higher than the CST + GS
by 2.56 kg (95%CI: 1.63–3.50, p < 0.001, Cohen’s d = 0.06), and higher than the control group
by 4.27 kg (95%CI: 3.35–5.19, p < 0.001, Cohen’s d = 0.39). For long jump performance, the
CST was 5.01 cm (95%CI: 1.65–8.38, p < 0.01, Cohen’s d = 0.21) higher than the GS group
and 5.17 cm (95%CI: 1.84–8.50, p < 0.01, Cohen’s d = 0.29) higher than the control group.
For 50 m dash performance, CST was faster than GS by 0.14 s (95%CI: 0.04–0.25, p < 0.01,
Cohen’s d = 0.25) and faster than control group by 0.26 s (95%CI: 0.16–0.36, p < 0.001, Cohen’s
d = 0.04); GS was faster than the control group by 0.12 s (95%CI: 0.01–0.22, p < 0.05, Cohen’s
d = 0.02); CST + GS was faster than the control group by 0.21 s (95%CI: 0.10–0.31, p < 0.001,
Cohen’s d = 0.06). For 800/1000 m running performance, the CST speed was 0.24 min faster
than GS (95%CI: 0.12–0.35, p < 0.001, Cohen’s d = 0.25) and 0.13 min faster than the control
group (95%CI: 0.01–0.24, p < 0.001, Cohen’s d = 0.09); CST + GS was 0.29 min faster than
GS (95%CI: 0.18–0.40, p < 0.001, Cohen’s d = 0.58); CST + GS was 0.18 min faster than the
control group (95%CI: 0.07–0.29, p < 0.01, Cohen’s d = 0.41). For core strength scores, CST
was higher than GS by 8.13 points (95%CI: 0.57–15.70, p < 0.05), higher than the control
group by 15.88 points (95%CI: 8.37–23.38, p < 0.001); CST + GS was higher than CST by
13.14 points (95%CI: 5.34–20.75, p < 0.01), higher than GS by 21.27 points (95%CI: 13.65–28.9,
p < 0.001), and higher than the control group by 20.02 points (95%CI: 21.52–36.52, p < 0.001).
Figure 5 shows the results of the post-hoc test between GS, CST, GS + CST, and CON.
Int.
Int. J.J. Environ.
Environ. Res.
Res.Public
PublicHealth
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2022,19,
19,7715
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50 d = 0.27 50 d = 0.39 20
left-hand grip strength( kg)

right-hand grip strength(kg)


✱✱✱
d = 0.04
✱✱✱ ✱✱✱
d = 0.06
40 d = 0.05 40 ✱✱✱ d = 0.02
✱✱✱ 15
d = 0.43 ✱
d = 0.32 ✱✱✱ d = 0.34 d = 0.31 d = 0.06

50 m(s)
30 d = 0.19 30 d = 0.06
✱✱✱ ✱ ✱ ✱✱✱ ✱✱ ✱✱✱
10
20 20
5
10 10

0 0 0
CST GS CST+GS CON CST GS CST+GS CON CST GS CST+GS CON

300 d = 0.21 10 ✱✱✱ d = 0.63


✱✱

core endurance(score)
d = 0.09 120 ✱ d = 0.13
d = 0.29 8 ✱
800/1000 m(min)

✱✱
long jump(cm)

200 d = 0.58 ✱✱ d = 0.52


d = 0.25d = 0.41 90
6 ✱✱✱ ✱✱✱ ✱✱ d = 0.78 d = 0.95
✱✱✱ ✱✱✱
d = 0.29
4 60 ✱
100
2 30

0 0 0
CST GS CST+GS CON CST GS CST+GS CON CST GS CST+GS CON

Figure
Figure 5. Descriptive
Descriptive statistics,
statistics, between-group
between-group variations
variations of
of means
means of
of physical
physical fitness. GS: GS: Goal
Goal
setting
setting intervention
intervention group;
group; CST:
CST: Core
Core strength
strength training
training intervention
intervention group;
group; GSGS ++ CST:
CST: Goal
Goal setting
setting
and
and core
core strength
strength training
training cointervention
cointervention group;
group; CON:
CON: Control
Control group;
group; “*”:
“*”: pp << 0.05;
0.05; “**”:
“**”: pp <<0.01;
0.01;
“***”: p < 0.001.
“***”: p < 0.001.

3.2.
3.2. Effects
Effects of
of Intervention
Intervention onon Students’
Students’ Exercise
Exercise Attitude
Attitude
ANOVA
ANOVA was was used to test for between-group differences in the baseline tests. The The
results
results showed
showed that that there
there were
were significant
significant differences
differences inin the
the exercise
exerciseattitude
attitudecomponent,
component,
except
except for
for target
target attitudes
attitudes and
and behavioral perceptions (p >> 0.05). 0.05).
Table
Table 6 6present
present the descriptive
the descriptive statisticsstatistics for the
for the students’ students’ preintervention
within-group within-group
and postintervention
preintervention attitudes toward exercise.
and postintervention attitudes The results
toward of within-group
exercise. differences
The results of within-in
students’
group attitudesintoward
differences exercise
students’ indicators
attitudes toward showed
exercisenoindicators
significantshowed
changesnoinsignificant
any of the
eight dimensions
changes in any of the of exercise attitudes among
eight dimensions students
of exercise in CST,
attitudes GS +students
among CST, or CON,
in CST,but
GSGS+
CST, or CON, but GS showed a significant decrease in two indicators: Target attitude0.23)
showed a significant decrease in two indicators: Target attitude (p = 0.028, Cohen’s d = (p =
and behavioral
0.028, Cohen’s d =habits
0.23) (p
and= 0.04, Cohen’shabits
behavioral d = 0.16).
(p = 0.04, Cohen’s d = 0.16).
Table 7 presents the descriptive statistics of the students’ pre- and post-intervention
intergroup attitudes toward exercise. After adjustment for covariates, behavioral habits
(F = 3.668, p = 0.013, η 2 p = 0.031), behavioral intentions (F = 3.354, p = 0.019, η 2 p = 0.028),
and sense of behavioral control (F = 3.802, p = 0.011, η 2 p = 0.032) showed statistically signif-
icant differences between groups. We found no significant mixed ANCOVA interactions
between groups or gender for behavioral attitudes, target attitudes, behavioral perceptions,
behavioral habits, behavioral intention, emotional experience, sense of behavioral control,
or subjective standards.
Int. J. Environ. Res. Public Health 2022, 19, 7715 14 of 19

Table 6. Descriptive statistics of exercise attitude (mean, standard deviation); within-group analysis.

Variables GS CST GS + CST CON


[Score] Pre Post d Pre Post d Pre Post d Pre Post d
Behavioral 30.2, 29.5, 29.1, 29.5, 32.8, 33.0, 31.0, 31.0,
0.13 0.05 5.96 0.04
attitudes 6.0 6.2 6.7 7.0 5.9 6.0 6.3 6.0
Target 49.1, 47.5, 47.9, 47.8, 51.0, 50.8, 49.6, 48.5,
0.23 * 0.01 7.97 0.03
attitudes 6.6 7.4 8.6 8.5 7.4 8.0 8.0 7.0
Behavioral 28.1, 28.3, 27.6, 27.8, 29.2, 28.9, 28.4, 28.9,
0.04 0.04 4.75 0.05
perceptions 3.9 6.8 4.9 4.9 4.5 4.8 4.6 4.8
Behavioral 31.6, 30.2, 29.9, 30.4, 34.5, 35.1, 31.6, 31.8,
0.16 * 0.06 7.96 0.08
habits 8.8 9.0 9.0 9.5 9.0 8.0 8.0 8.0
Behavioral 23.9, 23.1, 23.1, 23.9, 27.4, 27.7, 24.5, 24.5,
0.12 0.12 6.84 0.04
intention 6.8 7.0 7.4 7.4 7.3 6.8 6.8 7.1
Emotional 32.9, 33.3, 33.1, 34.4, 37.4, 37.8, 34.8, 35.4,
0.04 0.14 8.20 0.05
experience 9.6 8.4 8.6 9.2 8.4 8.2 8.5 8.7
Sense of
24.2, 23.4, 24.0, 25.1, 26.5, 27.4, 25.7, 24.9,
Behavioral 0.12 0.15 6.95 0.13
6.8 6.2 7.1 7.5 6.9 7.0 6.4 7.3
Control
Subjective 20.7, 20.3, 20.8, 21.3, 22.4, 21.8, 20.1, 21.0,
0.07 0.11 4.69 0.13
standards 5.7 5.7 4.6 5.1 5.3 4.7 4.9 4.6
GS: Goal setting intervention group; CST: Core strength training intervention group; GS + CST: Goal setting
and core strength training cointervention group; CON: Control group; statistical significance was set to p < 0.05;
“*”: p < 0.05.

Table 7. Analysis of covariance of exercise attitude test indexes between experimental and control
groups.

Variables Group Gender Interaction Effects Pairwise Comparison


[Score] F η2 F η2 F η2 Post
p p p

Behavioral
2.620 0.022 3.327 0.010 0.192 0.002 —
attitudes
Target
1.674 0.014 2.294 0.007 1.066 0.009 —
attitudes
Behavioral
0.218 0.002 0.040 0.000 0.237 0.002 —
perceptions
Behavioral CST + GS > GS,
3.668 0.031 * 5.362 0.015 * 0.063 0.001
habits CST + GS > CST
Behavioral
3.354 0.028 * 2.652 0.008 1.230 0.011 CST + GS > GS
intention
Emotional
1.156 0.010 0.012 0.000 1.210 0.010 —
experience
Sense of CST + GS > GS,
behavioral 3.802 0.032 * 6.589 0.019 * 0.353 0.003 CST > GS,
control CST + GS > con
Subjective
1.286 0.011 0.129 0.000 1.103 0.010 —
standards
The p-value is the result of the covariance test, setting age, BMI, and baseline test as covariates and group and
gender as fixed factors. “*”: p < 0.05.

Variables with significant differences were compared with Bonferroni post-hoc to


further understand the differences between the four groups. For behavioral habits, the
CST + GS was higher than the CST by 2.14 points (95%CI: 0.04–4.24, p < 0.05, Cohen’s d = 0.54)
and higher than the GS group by 3.47 points (95%CI: 01.40–5.55, p < 0.05, Cohen’s d = 0.62).
For behavioral intention: scores were 2.93 higher in the CST + GS group than in the GS
(95%CI: 1.11–4.75, p < 0.05, Cohen’s d = 0.69). For sense of behavioral control, the CST + GS
group was higher than the GS group by 2.8 points (95%CI: 1.0–4.6, p < 0.05, Cohen’s d = 0.63)
and higher than the control group by 2.07 points (95%CI: 0.29–3.84, p < 0.05, Cohen’s d = 0.35);
the CST group was higher than the GS group by 2.0 points (95%CI: 0.21–3.78, p < 0.05,
CST + GS > GS, CST + GS >
Behavioral habits 3.668 0.031 * 5.362 0.015 * 0.063 0.001
CST
Behavioral intention 3.354 0.028 * 2.652 0.008 1.230 0.011 CST + GS > GS
Emotional experience 1.156 0.010 0.012 0.000 1.210 0.010 —
CST + GS > GS, CST > GS,
Sense
Int. of behavioral
J. Environ. control
Res. Public Health 2022, 19,3.802
7715 0.032 * 6.589 0.019 * 0.353 0.003 15 of 19
CST + GS > con
Subjective standards 1.286 0.011 0.129 0.000 1.103 0.010 —
The p-value is the result of the covariance test, setting age, BMI, and baseline test as covariates and
Cohen’s
group d =gender
and 0.27). as
Figure
fixed 6factors.
shows“*”:
thepresults
< 0.05. of the post-hoc test between GS, CST, GS + CST,
and CON.

60 40 40

Sence of Behavioral Control


d = 0.54 d = 0.69
✱ d = 0.27 d = 0.63 d = 0.35

Behavioral Intentions
✱✱ ✱ ✱✱ ✱
Behavioral Habits

45 d = 0.62 30 30
✱✱

30 20 20

15 10 10

0 0 0
CST GS CST+GS CON CST GS CST+GS CON CST GS CST+GS CON

Figure
Figure 6.
6. Descriptive
Descriptive statistics,
statistics, between-group
between-group variations
variations of
of means
means of
of exercise attitude (behavioral
(behavioral
habits, behavioral intention, sense of behavioral control). GS: Goal setting
habits, behavioral intention, sense of behavioral control). GS: Goal setting intervention group;group;
intervention CST:
Core strength training intervention group; GS + CST: Goal setting and core strength
CST: Core strength training intervention group; GS + CST: Goal setting and core strength trainingtraining
cointervention group; CON: Control group; “*”: p < 0.05; “**”: p < 0.01.
cointervention group; CON: Control group; “*”: p < 0.05; “**”: p < 0.01.

4.
4. Discussion
Discussion
Our
Our findings indicate
indicatethatthatour
ourintervention
interventionwas was more
more effective
effective when
when wewe combined
combined the
the
GS GS intervention
intervention withthe
with the CST
CST intervention
intervention ininthethe physical
physical education
education classroom, i.e.,
classroom,
GS
i.e.,+GS
CST > CST
+ CST and and
> CST GS +GS CST > GS.
+ CST Influenced
> GS. by many
Influenced by manyfactors
factorssuch as the
such pressure
as the pressureof
entrance
of entrance exams andand
exams physical
physical exercise habits,
exercise students’
habits, students’daily time
daily spent
time in moderate-to-
spent in moderate-
to-vigorous
vigorous physical
physical activity
activity decreases
decreases significantly
significantly after
after thethe transition
transition fromfrom elementary
elementary to
to junior
junior highhigh school,
school, andand schools
schools mustplay
must playananimportant
importantrole role in in promoting
promoting physical
physical
exercise among
exercise among junior
junior high
high school
school students.
students. PE PE class
class isis the
the basic
basic organizational
organizational form form ofof
school physical education, and they are important for students for
school physical education, and they are important for students for improving their improving their physical
fitness, motor
physical skills,
fitness, motor and overall
skills, andhealth
overall and for developing
health lifelong awareness
and for developing of physical
lifelong awareness of
educationeducation
physical [57]. However, some schools
[57]. However, somehave turned
schools havePE classes
turned into boring preparation
PE classes into boring
activities foractivities
preparation the PE entrance
for the PE examination; students find
entrance examination; this “teaching
students find this to the test”todull,
“teaching the
and itdull,
test” has shown negative
and it has shown effects sucheffects
negative as decreasing
such asstudents’
decreasing motivation
students’tomotivation
exercise andto
failing to develop students’ techniques and skills, especially for some
exercise and failing to develop students’ techniques and skills, especially for some low- low-intensity sports.
Physical sports.
intensity education teachers
Physical need toteachers
education find a balance
need to between ensuring
find a balance the completion
between ensuring the of
classroom tasks and improving students’ physical fitness. The results
completion of classroom tasks and improving students’ physical fitness. The results of the of the effectiveness
analysis of this
effectiveness study’s
analysis of intervention showed thatshowed
this study’s intervention interspersing short periods
that interspersing of fun
short core
periods
strength combination exercises with the aid of students’ favorite agility ladders in the
physical education classroom improved their physical fitness and promoted their physical
activity behaviors, behavioral intentions, and sense of behavioral control.
Existing studies have found that CST has an enhancing effect on balance [58,59],
strength [60], specific speed qualities [61], and dynamic postural control [62] and that
core strength interventions have positive effects on sports performance and promoting
athletic ability. After reviewing 16 experimental research papers on the effects of core
strength on athletic ability, Fu et al. found that CST was able to positively affect the basic
athletic abilities of running, jumping, throwing, swimming, and rowing relative to general
training, with greater effects on running and jumping than on throwing, swimming, and
rowing [63]. Additionally, after reviewing 44 experimental research papers on the effects of
CST on athletic performance, this research team found positive effects of improved running,
jumping, and distal speed category performance, especially for stability; we also found that
the number of training weeks was positively correlated with the amount of effect [64]. A
literature review of 34 randomized controlled trials of core strength interventions by Niu
et al. (2018) found that CST has important value in improving muscle control, maintaining
Int. J. Environ. Res. Public Health 2022, 19, 7715 16 of 19

overall body posture, playing a transmission role in the core region in the kinetic chain,
and improving core stability in athletes [65]. Electromyographic studies have shown that
enhanced core strength can reduce the discharge of the posterior musculature of the swing
leg during high-speed running vacations, so that the leg muscles can be relaxed, reducing
energy expenditure during the short vacating time to prepare for the next contraction to
generate more force [66]. The results of this study are consistent with those from existing
studies that show that CST with short-duration single exercises and a cumulative frequency
of multiple reps has a beneficial effect on the physical fitness levels of junior high school
students.
The positive effects of the GS-based intervention in this study on middle school
students’ physical fitness and physical activity attitudes were not as significant as the
effects of the physical education classroom intervention and the combination intervention,
but they were significantly higher than the findings for the control group. The results are
also consistent with the results of the original trials of behavioral interventions through
GS, such as GS interventions for adolescent nutrition education [67]; adolescent daily
step improvement [11,68]; and aerobic fitness for students in grades 6–8 [32], all of which
had significant positive effects. A systematic review by Epton et al. [69] of 141 papers on
behavioral interventions through GS found that GS has positive intervention effects, is
an effective approach to behavior change, and can be considered an essential component
of conducting successful interventions. Desmond et al. [70], after a systematic review
of 45 experimental literature on interventions for physical activity behaviors through
multicomponent GS, noted that GS interventions related to physical activity behaviors had
moderate positive effects (Cohen’s d = 0.552). Short-term goals are the most likely to have
an immediate motivational impact on human action, and clear, specific, measurable goals
generate a greater motivational drive and lead to good grades [71,72]. Educating students
about GS is a viable and potentially effective strategy for promoting increased physical
activity and physical health promotion.

5. Conclusions
The present parallel study design shows that CST in a PE class provides concentrated
benefits in core endurance that students in other physical fitness groups did not show. CST
should be considered an element to be introduced in comprehensive strength training. The
use of fun combinations of exercises can be beneficial in increasing students’ motivation
to practice in PE class. Assisting students with GS for exercise did not have a significant
effect on improving students’ attitudes toward exercise; however, combining GS with core
strength exercise interventions had a significant effect on improving students’ physical
fitness that was greater than that for the core strength interventions alone. As for the
scientific evidence and practical implications, we conclude that CST combined with GS has
significant advantages for improving students’ physical fitness.

Author Contributions: K.Y. designed the stud and participated in statistical analysis. Y.L. designed
the study, collected the data, and drafted the manuscript. Y.L and K.Y. contributed intellectually to
improve and revise the manuscript. X.G. played a role in data collection. All authors have read and
agreed to the published version of the manuscript.
Funding: This study was funded by the National Social Science Foundation Key Program Project
(#17ATY009) and Double First-Class Construction Fund of Zhejiang University.
Institutional Review Board Statement: The study procedures were approved by the research ethics
board of Zhejiang University (No. 2020-002, 22 July 2020).
Informed Consent Statement: Informed consent was obtained from all subjects.
Data Availability Statement: The datasets used and/or analyzed during the current study are
available from the corresponding author upon reasonable request.
Acknowledgments: The authors thank all the students who participated in the study.
Int. J. Environ. Res. Public Health 2022, 19, 7715 17 of 19

Conflicts of Interest: The authors declare no conflict of interest.

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