To explore the intervention effect of school-based horticultural activities combined with fancy rope skipping on the health behaviour of fourth-grade primary school students, so as to provide a reference method for children's health promotion.

Eighty-five primary school students in grade 4 of a primary school in Changsha City were selected in March 2023 by using multi-stage cluster random sampling method and randomly divided into an intervention group (43 students) and a control group (42 students). The intervention group implemented a 12-week comprehensive intervention of "school-based gardening combined with pattern skipping, once a week 90 min/time including routine practice (weeks 1-5, 7-11; the contents were vegetable and plant management, theoretical knowledge learning of pattern skipping practice, etc.) and parent-child activities (weeks 6 and 12; vegetable salad making, synchronized jumping rope competition, etc.), and the control group maintained the regular curriculum. Moderate to vigorous physical activity (MVPA) and sleep duration were monitored by accelerometers in grade 4 primary school students, combined with questionnaires to assess fruit and vegetable intake and video screen behaviour, and generalised estimating equations were used to analyse the data.

After the intervention, there were interaction effect for school day MVPA time (Wald χ²_group×time=8.27), vegetable intake (Wald χ²_group×time=4.35), and video screen time (Wald χ²_group×time=13.27) in both groups (P < 0.01). After the intervention, the MVPA time in the intervention group increased from 30.00 (20.00, 60.00) min to 40.00 (30.00, 60.00) min from school day; vegetable intake increased from 99.85 (33.95, 229.48) g to 190.15 (131.05, 279.48) g; and video screen time increased from 225.00 (110.00, 313.75) min to 60.00 (30.00, 142.50) min (Z=-4.51, -2.00, -3.84, P < 0.05). However, there were no statistical differences in MVPA time, fruit intake and sleep time before and after intervention in the intervention group on weekends (Z=-1.35, -0.85, -0.24, P>0.05).

School-based horticultural activities combined with an integrated intervention of fancy rope skipping can significantly improve physical activity, vegetable intake and video screen behaviours on weekdays in grade 4 primary school children, in order to provide a basis for multidimensional health promotion.