The effect of physical activity interventions on physical literacy in preschool children: a systematic review with meta-analysis

Abstract Background Physical literacy is a crucial foundation for lifelong health, and early childhood is a critical period for its development. While physical activity interventions are believed to enhance physical literacy, previous reviews have often focused on isolated outcomes, creating a fragmented evidence base. This study aimed to bridge this gap by comprehensively evaluating the effect of physical activity interventions across all five domains of physical literacy (physical, cognitive, affective, social, and behavioral) in preschool children. Methods This systematic review and meta-analysis was conducted according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered with PROSPERO (CRD42024528162). Ten databases were searched from inception to August 1, 2024. Quantitative studies investigating the effects of physical activity related interventions on one or more domains of physical literacy in typically developing children aged 3–6 years were included. A random-effects model was used to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed to explore sources of heterogeneity and identify potential moderators. Results A total of 203 studies ( N = 30,521) were included in the systematic review, and 164 studies ( N = 23,073) in the meta-analysis. Physical activity interventions were associated with a positive effect on overall physical literacy (SMD = 0.61, 95% CI: 0.54–0.68). The effects were moderate-to-large for the physical domain (SMD = 0.71, 95% CI: 0.61–0.81) and small-to-moderate for the cognitive (SMD = 0.53, 95% CI: 0.39–0.67), affective (SMD = 0.46, 95% CI: 0.27–0.64), social (SMD = 0.50, 95% CI: 0.34–0.67) and behavioral (SMD = 0.44, 95% CI: 0.24–0.63) domains. High heterogeneity was present across all domains. Subgroup analyses revealed that factors such as facilitator type, intervention duration, control group type, and target population significantly moderated the intervention effects. Conclusions Physical activity interventions show significant potential for improving all domains of physical literacy in preschool children. However, the evidence is marked by high heterogeneity and a notable bias towards physical outcomes in the existing literature. To optimize impact, practitioners and policymakers should consider the identified moderators when designing interventions.