ackground
Physical activity plays a crucial role for primary and secondary prevention of various chronic diseases that can lead to premature morbidity and mortality.

Purpose
This study was designed to investigate (a) elementary boys’ and girls’ voluntary participation in team handball during recess, while it was being simultaneously taught in physical education (the intervention phase) and after the physical education lessons had concluded (maintenance phase); and (b) the moderate-to-vigorous physical activity (MVPA) levels during physical education, team handball recess, and traditional recess.

Methods
One hundred thirty third grade elementary school children (53 girls, 77 boys) from six schools were taught a 10-lesson team handball unit during physical education. Ten team handball recess sessions (20 min) were organized during lunch recess in which children could voluntarily participate. Systematic observation was used to assess children’s MVPA in all settings.

Results
There were no significant differences between boys (49%) and girls (55%) for participation in team handball recess during intervention and maintenance phases. Boys achieved more MVPA in physical education (33% vs 29%, p < .001), team handball recess (52% versus 47%, p < .05) and traditional recess (51% versus 40%, p < .05) compared to girls.